Χαρακτηριστικά και έκβαση παιδιών με σάρκωμα Ewing υψηλού και πολύ υψηλού κινδύνου. Η εμπειρία 10χρόνων του Ογκολογικού Τμήματος Γ.Ν. Παίδων Π. & Αγλαΐας Κυριακού

Έγινε μια προσπάθεια καταγραφής των παιδιών που νόσησαν με σάρκωμα Ewing από το 2010 έως και το 2020 και νοσηλεύτηκαν στο Ογκολογική Τμήμα του Νοσοκομείου Παίδων Αθηνών Π. & Αγλαΐας Κυριακού στο ΄΄Ελπίδα’’. Οι ασθενείς αναλύθηκαν ως προς το φύλο, την ηλικία, την εντόπιση της νόσου, τον αρχικό όγκο της νόσου, την ύπαρξη μεταστάσεων στη διάγνωση, την υποτροπή, την επιβίωση χωρίς συμβάντα (EFS) καθώς και τη συνολική επιβίωση όλων των παιδιών αλλά και ανά ομάδα κινδύνου. Ο μέσος όρος ηλικίας των 28 ασθενών είναι 10,59 έτη. Για τη στατιστική ανάλυση χρησιμοποιήθηκαν οι καμπύλες Kaplan- Meier. Στο 25% των ασθενών η νόσος ήταν μεταστατική στην αρχική διάγνωση (μόνο πνευμονικές μεταστάσεις). Η συνολική επιβίωση (OS) των ασθενών ήταν 59,3%. H ύπαρξη μετάστασης την ημέρα της διάγνωσης μείωσε σημαντικά τη συνολική επιβίωση (0%). OS 84,6% σε παιδιά με SR ES, 71,4% για ασθενείς υψηλού κινδύνου και 0% για τους ασθενείς πολύ υψηλού κινδύνου. Η επιβίωση μετά από υποτροπή είναι 23,07% με 7,7% σε CR2. Το ποσοστό επιβίωσης παιδιατρικών ασθενών με σάρκωμα Ewing που υποβλήθηκαν σε θεραπεία στο Ογκολογικό Τμήμα του Νοσοκομείου Παίδων Π. & Αγλαΐας Κυριάκου της Αθήνας είναι παρόμοιο με το αποτέλεσμα στις χώρες της Δυτικής Ευρώπης.The survival of children treated with Ewing sarcoma at the Oncology Department of P. & Aglaia Kyriakou Children Hospital of Athens, were investigated. Pediatric patients with Ewing sarcoma treated from 2010 through 2020 were analyzed in terms of event free survival from diagnosis, overall survival and clinical factors (age, sex, primary localization and extent of the tumor, time interval from diagnosis to relapse of the disease, EFS and OS). For statistical analysis Kaplan-Meier estimated survival. Mean age of the 28 patients were10,59. In 25% of the patients the disease was metastatic at primary diagnosis (pulmonary only). Overall survival of patients were 59,3%. Among the analyzed factors, the presence of metastasis at the day of diagnosis impaired overall survival significantly to 0%. OS of children with SR ES is 84.6%, 71,4% for HR patients and 0% for children with VHR ES. Survival after relapse of the disease is 23,07% and 7,7% are in CR2. The survival rate of pediatric patients with Ewing sarcoma treated at the Oncology Department of P. & Aglaia Kyriakou Children Hospital of Athens is similar to the result in Western European countries

Predictive Factors for Gram-negative Versus Gram-positive Bloodstream Infections in Children With Cancer

Background: Identifying potential predictive factors for the type of bacteremia (Gram-negative vs. Gram-positive) in children with cancer would be crucial for the timely selection of the appropriate empiric antibiotic treatment. Materials and Methods: Demographic, clinical, and laboratory characteristics of children with cancer and a bacterial bloodstream infection (BSI) (February 1, 2011 to February 28, 2018) in a tertiary pediatric oncology department were retrospectively examined and were correlated with the type of isolated bacteria. Results: Among 224 monomicrobial bacterial BSI episodes, Gram-negative and Gram-positive bacteria were isolated in 110 and 114 episodes, respectively. Gram-negative bacteria were isolated significantly more frequently in girls (Gram-negative/Gram-positive ratio 1.7:1) versus boys (Gram-negative/Gram-positive ratio 0.72:1), P=0.002, in patients with previous BSI episodes (1.4:1) versus those without (0.8:1), P=0.042, and in children with hematologic malignancy (1.3:1) versus those who suffered from solid tumors (0.52:1), P=0.003. Gram-negative BSI episodes were more frequently correlated with a lower count of leukocytes, P=0.009, neutrophils, P=0.009 and platelets, P=0.002, but with significantly higher C-reactive protein (CRP) levels, P=0.049. Female sex, hematologic malignancy, and higher CRP levels remained independent risk factors for Gram-negative BSI in the multivariate analysis. Among neutropenic patients, boys with solid tumors and a recent central venous catheter placement appear to be at increased risk for Gram-positive BSI in the multivariate analysis. Conclusions: Although Gram-negative and Gram-positive BSIs are close to balance in children with cancer, Gram-negative bacteria are more likely to be isolated in girls, children with hematologic malignancies and those with higher CRP level at admission. In contrast, neutropenic boys with solid tumors and a recently placed central venous catheter may be at increased risk for Gram-positive BSI indicating probably the need for initially adding antibiotics targeting Gram-positive bacteria

Acinar cell carcinoma in childhood: A case report of a very rare tumor

Pancreatic tumors are reported rarely in childhood and represent an extremely rare entity in Pediatric Oncology. One of the least common types of pediatric pancreatic tumor is acinar cell carcinoma (ACC). We aim to present a rare case of ACC and the difficulties we faced during diagnosis and treatment