Successful eradication of chronic myeloid leukemia in a child despite allogeneic graft rejection

Background Chronic myeloid leukemia (CML) is a rare disease in children and treated with tyrosine kinase inhibitors (TKI) and with allogeneic hematopoietic stem cell transplantation (HSCT) still in many cases. Case We describe an 8-year-old patient with CML treated with two different TKIs before proceeding to allogeneic HSCT. Despite successful engraftment, prompt rejection of the graft was followed by autologous reconstitution. TKI therapy was reintroduced post-rejection in anticipation of relapse but shortly discontinued due to low white blood cell and neutrophil counts. The patient has remained disease-free over 5 years after graft rejection and without further therapy. Conclusion This case suggests that even a short antileukemic effect by an allogeneic transplant may succeed in eradicating CML.Non peer reviewe

Lasten pienentyneet valkosolumäärät

Lasten pienentyneet valkosolumäärät johtuvat tavallisesti neutrofiilisten granulosyyttien määrän vähentymisestä. Yleensä kyseessä on ohimenevä virusinfektioihin liittyvä ilmiö. Imeväisiässä ja varhaislapsuudessa immuunivälitteiset neutropeniat ovat mahdollisia pitkittyneen leukopenian aiheuttajia. Harvinaisia leukopenian aiheuttajia on lukuisia, ja taustalla voi olla synnynnäinen luuydinsairaus, jokin oireyhtymä tai pahanlaatuinen veritauti. Neutropeniaan liittyvä infektioriski on suurentunut nimenomaan niillä potilailla, joiden neutropenian taustalla on luuytimen tuotantovika. Jatkotutkimukset ovat tarpeen, mikäli pienentyneisiin valkosoluarvoihin liittyy merkittäviä infektioita, muita hematologisia poikkeavuuksia tai poikkeavia kliinisiä löydöksiä

Syöpälääketutkimus lasten lääketutkimuksen eturintamassa

Teema : lastenlääkkeet. English summar

Bioimpedance spinal needle provides high success and low complication rate in lumbar punctures of pediatric patients with acute lymphoblastic leukemia

Publisher Copyright: © 2022, The Author(s).In this prospective single-arm study of 50 pediatric patients with acute lymphoblastic leukemia (ALL), we evaluated the clinical performance of a novel bioimpedance spinal needle system in 152 intrathecal treatment lumbar punctures (LP) of these patients. The system detects in real-time when the needle tip reaches the cerebrospinal fluid (CSF) in the spinal canal. The success was defined as getting a CSF sample and/or administering the intrathecal treatment with one needle insertion. Incidence of traumatic LP (TLP) was defined as ≥ 10 erythrocytes/µL of CSF. Post-procedural complications were monitored with a one-week diary and one-month register follow-up. The success of the first attempt was 79.5%, with the CSF detection sensitivity of 86.1%. The incidence of TLP was 17.3%. A successful first attempt was associated with a significantly lower incidence of TLP (10% vs 40%, p = 0.0015). During the week after the procedure, the incidence of post-dural puncture headache was 6%. During the follow-up, no major complications were observed. In conclusion, the novel bioimpedance spinal needle system achieved a high success rate and low incidence of TLP and other complications in pediatric patients with ALL in a real-world clinical setting, indicating clinical utility for this system in pediatric hemato-oncology.Peer reviewe

Lasten ja nuorten aikuisten akuutin lymfoblastileukemian hoito kehittyy

Teema : Hematologiset syövät. English summaryPeer reviewe