@article {3598, title = {Complete remission of VZV reactivation treated with valganciclovir in a patient with total lymphocyte depletion and acute kidney injury after allogeneic bone marrow transplantation.}, journal = {APMIS}, volume = {123}, year = {2015}, month = {2015 Jan}, pages = {77-80}, abstract = {

Varicella zoster virus (VZV), a threat for hematopoietic stem cell transplantation (HSCT) recipients, is still one of the most common viral pathogens that affect these patients with a reported incidence ranging between 17\% and 50\% in the post transplantation period. Valganciclovir (V-GCV), a valine ester pro-drug of GCV orally administrable, has recently shown great activity against CMV infections, but there are no reports of its clinical efficacy against VZV. We here report a case history of a patient with positive serologic test for VZV, who underwent allogeneic HSCT and developed an atypical varicella-like illness. First-line therapy with foscarnet had to be discontinued due rapid development of renal impairment (creatinine: 2.60 mg/dL, urea: 130.6 mg/dL) and therefore was switched to V-GCV. The renal impairment and skin lesions of the patient fully recovered after few days of therapy, even though the patient had complete lymphocyte depletion. This is the first case of a patient with chickenpox-like illness treated successfully with V-GCV.

}, keywords = {Acute Kidney Injury, Adolescent, Bone Marrow Transplantation, Fatal Outcome, Female, Ganciclovir, Herpes Zoster, Herpesvirus 3, Human, Humans, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Viral Load}, issn = {1600-0463}, doi = {10.1111/apm.12303}, author = {Maximova, Natalia and Antonio, Pizzol and Marilena, Granzotto and Rovere, Francesca and Tamaro, Paolo} } @article {3599, title = {Does Teno Torque Virus Induce Autoimmunity After Hematopoietic Stem Cell Transplantation? A Case Report.}, journal = {J Pediatr Hematol Oncol}, volume = {37}, year = {2015}, month = {2015 Apr}, pages = {e194-7}, abstract = {

Teno Torque virus, member of the family of Anelloviridae, has been associated with many autoimmune diseases such as idiopathic hepatitis, systemic lupus erythematosus, and multiple sclerosis. Its viral load tends to be higher in the bone marrow and in tissues with high turnover rate. We report here a case of an 11-month-old infant affected by acute myeloid leukemia who underwent hematopoietic stem cell transplantation, and after 6 months had autoimmune hepatitis and atopic dermatitis. Extremely high-cytokine IP-10 and eotaxin levels were found in her sera, and serological tests and RT-PCR for viruses showed positive results exclusively for Teno Torque virus.

}, keywords = {Autoimmune Diseases, Autoimmunity, Dermatitis, Atopic, DNA Virus Infections, DNA, Viral, Female, Hematopoietic Stem Cell Transplantation, Hepatitis, Humans, Infant, Leukemia, Myeloid, Acute, Prognosis, Torque teno virus, Viral Load}, issn = {1536-3678}, doi = {10.1097/MPH.0000000000000194}, author = {Maximova, Natalia and Pizzol, Antonio and Ferrara, Giovanna and Maestro, Alessandra and Tamaro, Paolo} } @article {8051, title = {Mature and immature teratoma: A report from the second Italian pediatric study.}, journal = {Pediatr Blood Cancer}, volume = {62}, year = {2015}, month = {2015 Jul}, pages = {1202-8}, abstract = {

BACKGROUND: Teratomas demonstrate a benign clinical behavior, however they may recur with malignant components or as teratoma, and in a small group of patients prognosis could be fatal. After the first Italian study, we collected cases of teratoma, alongside the protocol for malignant germ cell tumors.

PROCEDURE: Patients with teratoma were collected from 2004 to 2014. Teratomas were classified according to the WHO classifications, as mature and immature. Patients with pathological aFP and/or bHCG, and those with a malignant germ cell component were not included.

RESULTS: The study enrolled 219 patients (150 mature, 69 immature teratomas) with a median age at diagnosis of 42 months. The primary sites involved were: 118 gonadal and 101 extragonadal teratomas. Two females with ovarian teratoma had a positive family history. Complete and incomplete surgeries were performed in 85\% and 9\% of cases. Seventeen events occurred: six females had a second metachronous tumor (5 contralateral ovarian teratoma, 1 adrenal neuroblastoma) and 11 teratomas relapsed/progressed (3 mature, 8 immature teratomas). Two patients died, one of progressive immature teratoma and one of surgical complications. At a median follow up of 68 months, the event-free, relapse-free, and overall survival rates were 90.6\%, 94.3\%, 98.6\%, respectively.

CONCLUSIONS: Teratomas show a good prognosis, especially the mature ones: surgery and follow-up remain the standard approach. Incomplete surgery in immature teratoma is the group at greatest risk of relapse. Bilateral ovarian tumors are a possibility, and the rare family predisposition to ovarian mature teratoma warrants further analyses.

}, keywords = {Adolescent, Adult, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Incidence, Infant, Infant, Newborn, Italy, Male, Neoplasm Grading, Neoplasm Recurrence, Local, Neoplasm Staging, Neoplasms, Second Primary, Neuroblastoma, Ovarian Neoplasms, Prognosis, Prospective Studies, Survival Rate, Teratoma, Testicular Neoplasms, Young Adult}, issn = {1545-5017}, doi = {10.1002/pbc.25423}, author = {Terenziani, Monica and D{\textquoteright}Angelo, Paolo and Inserra, Alessandro and Boldrini, Renata and Bisogno, Gianni and Babbo, Gian Luca and Conte, Massimo and Dall{\textquoteright} Igna, Patrizia and De Pasquale, Maria Debora and Indolfi, Paolo and Piva, Luigi and Riccipetitoni, Giovanna and Siracusa, Fortunato and Spreafico, Filippo and Tamaro, Paolo and Cecchetto, Giovanni} } @article {7704, title = {Polyclonal gammopathy after BKV infection in HSCT recipient: a novel trigger for plasma cells replication?}, journal = {Virol J}, volume = {12}, year = {2015}, month = {2015}, pages = {23}, abstract = {

BACKGROUND: BK polyomavirus infects most of the general population. However, its clinical manifestations are almost exclusively seen in immunocompromised patients, particularly in kidney and hematopoietic stem cell transplantation recipients.

CASE PRESENTATION: A 15-y-old female suffering from common B-cell acute lymphoblastic leukaemia underwent hematopoietic stem cell transplantation. The patient had reactivation of BKPyV infection and developed an haemorrhagic cystitis. Three months after transplant, BKPyV viremia and viruria increased and she developed a severe nephropathy associated to a polyclonal gammopathy with high levels of isolated IgM.

CONCLUSION: This case report describes a rare and unexpected polyclonal gammopathy developed during a polyomavirus-associated nephropathy confirmed by immunohistochemical and laboratory analyses.

}, issn = {1743-422X}, doi = {10.1186/s12985-015-0254-z}, author = {Maximova, Natalia and Pizzol, Antonio and Sonzogni, Aurelio and Gregori, Massimo and Granzotto, Marilena and Tamaro, Paolo} } @article {3601, title = {Childhood high-risk acute lymphoblastic leukemia in first remission: results after chemotherapy or transplant from the AIEOP ALL 2000 study.}, journal = {Blood}, volume = {123}, year = {2014}, month = {2014 Mar 6}, pages = {1470-8}, abstract = {

The outcome of high-risk (HR) acute lymphoblastic leukemia patients enrolled in the AIEOP-BFM ALL 2000 study in Italy is described. HR criteria were minimal residual disease (MRD) levels >=10(-3) at day 78 (MRD-HR), no complete remission (CR) at day 33, t(4;11) translocation, and prednisone poor response (PPR). Treatment (2 years) included protocol I, 3 polychemotherapy blocks, delayed intensification (protocol IIx2 or IIIx3), cranial radiotherapy, and maintenance. A total of 312 HR patients had a 5-year event-free survival (EFS) of 58.9\% (standard error [SE] = 2.8) and an overall survival of 68.9\% (SE = 2.6). In hierarchical order, EFS was 45.9\% (4.4) in 132 MRD-HR patients, 41.2\% (11.9) in 17 patients with no CR at day 33, 36.4\% (14.5) in 11 patients with t(4;11), and 74.0\% (3.6) in 152 HR patients only for PPR. No statistically significant difference was found for disease-free survival in patients with very HR features [MRD-HR, no CR at day 33, t(4;11) translocation], given hematopoietic stem cell transplantation (HSCT) (n = 66) or chemotherapy only (n = 88), after adjusting for waiting time to HSCT (5.7 months). Patients at HR only for PPR have a favorable outcome. MRD-HR is associated with poor outcome despite intensive treatment and/or HSCT and may qualify for innovative therapies. The study was registered at www.clinicaltrials.gov as $\#$NCT00613457.

}, keywords = {Adolescent, Antineoplastic Combined Chemotherapy Protocols, Child, Child, Preschool, Combined Modality Therapy, Female, Hematopoietic Stem Cell Transplantation, Humans, Infant, Male, Neoplasm, Residual, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Radiotherapy, Remission Induction, Treatment Outcome}, issn = {1528-0020}, doi = {10.1182/blood-2013-10-532598}, author = {Conter, Valentino and Valsecchi, Maria Grazia and Parasole, Rosanna and Putti, Maria Caterina and Locatelli, Franco and Barisone, Elena and Lo Nigro, Luca and Santoro, Nicola and Aric{\`o}, Maurizio and Ziino, Ottavio and Pession, Andrea and Testi, Anna Maria and Micalizzi, Concetta and Casale, Fiorina and Zecca, Marco and Casazza, Gabriella and Tamaro, Paolo and La Barba, Gaetano and Notarangelo, Lucia Dora and Silvestri, Daniela and Colombini, Antonella and Rizzari, Carmelo and Biondi, Andrea and Masera, Giuseppe and Basso, Giuseppe} } @article {3558, title = {Hematopoietic stem cell transplantation effects on spinal cord compression in Hurler.}, journal = {Pediatr Transplant}, volume = {18}, year = {2014}, month = {2014 May}, pages = {E96-9}, abstract = {

Hurler syndrome type 1 (MPS-1) is an autosomal recessive lysosomal disorder due to the deficiency of the enzyme alpha-L-iduronidase which is necessary for the degradation of dermatan and heparan sulfate. It is characterized by deposit of glycosaminoglycans in tissues, progressive multisystem dysfunction, and early death. HSCT for children with MPS-I is effective, resulting in increased life expectancy and improvement of clinical parameters. The spinal MRI performed on a female 10 yr old undergoing HSCT at the age of 18 months and receiving ERT revealed a considerable decrease in soft tissue around the tip of odontoid causing a significant reduction in spinal cord compression. In light of this result, we suppose that combined ERT and HSCT are successful in Hurler I disease.

}, keywords = {Bone Marrow Transplantation, Child, Enzyme Replacement Therapy, Female, Glycosaminoglycans, Hematopoietic Stem Cell Transplantation, Humans, Iduronidase, Magnetic Resonance Imaging, Mucopolysaccharidosis I, Odontoid Process, Spinal Cord Compression, Treatment Outcome}, issn = {1399-3046}, doi = {10.1111/petr.12231}, author = {Ferrara, Giovanna and Maximova, Natalia and Zennaro, Floriana and Gregori, Massimo and Tamaro, Paolo} } @article {1822, title = {Foreign children with cancer in Italy.}, journal = {Ital J Pediatr}, volume = {37}, year = {2011}, month = {2011}, pages = {44}, abstract = {

BACKGROUND: There has been a noticeable annual increase in the number of children coming to Italy for medical treatment, just like it has happened in the rest of the European Union. In Italy, the assistance to children suffering from cancer is assured by the current network of 54 centres members of the Italian Association of Paediatric Haematology and Oncology (AIEOP), which has kept records of all demographic and clinical data in the database of Mod.1.01 Registry since 1989.

METHODS: We used the information stored in the already mentioned database to assess the impact of immigration of foreign children with cancer on centres{\textquoteright} activity, with the scope of drawing a map of the assistance to these cases.

RESULTS: Out of 14,738 cases recorded by all centres in the period from 1999 to 2008, 92.2\% were born and resident in Italy, 4.1\% (608) were born abroad and living abroad and 3.7\% (538) were born abroad and living in Italy. Foreign children cases have increased over the years from 2.5\% in 1999 to. 8.1\% in 2008.Most immigrant children came from Europe (65.7\%), whereas patients who came from America, Asia and Oceania amounted to 13.2\%, 10.1\%, 0.2\%, respectively. The immigrant survival rate was lower compared to that of children who were born in Italy. This is especially true for acute lymphoblastic leukaemia patients entered an AIEOP protocol, who showed a 10-years survival rate of 71.0\% vs. 80.7\% (p < 0.001) for immigrants and patients born in Italy, respectively.

CONCLUSIONS: Children and adolescents are an increasingly important part of the immigration phenomenon, which occurs in many parts of the world. In Italy the vast majority of children affected by malignancies are treated in AIEOP centres. Since immigrant children are predominantly treated in northern Italy, these centres have developed a special expertise in treating immigrant patients, which is certainly very useful for the entire AIEOP network.

}, keywords = {Adolescent, Africa, Asia, Child, Child, Preschool, Databases, Factual, Emigrants and Immigrants, Ethnic Groups, Europe, Eastern, European Union, Female, Humans, Incidence, Infant, Infant, Newborn, Italy, Male, Neoplasms, North America, Oceania, Prevalence, Retrospective Studies, South America, Survival Rate}, issn = {1824-7288}, doi = {10.1186/1824-7288-37-44}, author = {Rondelli, Roberto and Dini, Giorgio and De Rosa, Marisa and Quarello, Paola and Bisogno, Gianni and Aric{\`o}, Maurizio and Vasconcelos, Carivaldo and Tamaro, Paolo and Casazza, Gabriella and Zecca, Marco and De Laurentis, Clementina and Porta, Fulvio and Pession, Andrea} }