@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 {3608, title = {Single-day trimethoprim/sulfamethoxazole prophylaxis for Pneumocystis pneumonia in children with cancer.}, journal = {J Pediatr}, volume = {164}, year = {2014}, month = {2014 Feb}, pages = {389-92.e1}, abstract = {

OBJECTIVE: To determine whether a simplified, 1-day/week regimen of trimethoprim/sulfamethoxazole is sufficient to prevent Pneumocystis (jirovecii [carinii]) pneumonia (PCP). Current recommended regimens for prophylaxis against PCP range from daily administration to 3 consecutive days per week dosing.

STUDY DESIGN: A prospective survey of the regimens adopted for the PCP prophylaxis in all patients treated for childhood cancer at pediatric hematology-oncology centers of the Associazione Italiana Ematologia Oncologia Pediatrica.

RESULTS: The 20 centers participating in the study reported a total of 2466 patients, including 1093 with solid tumor and 1373 with leukemia/lymphoma (or primary immunodeficiency; n = 2). Of these patients, 1371 (55.6\%) received the 3-day/week prophylaxis regimen, 406 (16.5\%) received the 2-day/week regimen, and 689 (27.9\%), including 439 with leukemia/lymphoma, received the 1-day/week regimen. Overall, only 2 cases of PCP (0.08\%) were reported, both in the 2-day/week group. By intention to treat, the cumulative incidence of PCP at 3 years was 0.09\% overall (95\% CI, 0.00-0.40\%) and 0.51\% for the 2-day/week group (95\% CI, 0.10\%-2.00\%). Remarkably, both patients who failed had withdrawn from prophylaxis.

CONCLUSION: A single-day course of prophylaxis with trimethoprim/sulfamethoxazole may be sufficient to prevent PCP in children with cancer undergoing intensive chemotherapy regimens. This simplified strategy might have implications for the emerging need for PCP prophylaxis in other patients subjected to the increased use of biological and nonbiological agents that induce higher levels of immune suppression, such as those with rheumatic diseases.

}, keywords = {Anti-Infective Agents, Child, Dose-Response Relationship, Drug, Drug Administration Schedule, Follow-Up Studies, Hematologic Neoplasms, Humans, Incidence, Italy, Pneumocystis carinii, Pneumonia, Pneumocystis, Prospective Studies, Treatment Outcome, Trimethoprim, Sulfamethoxazole Drug Combination}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2013.10.021}, author = {Caselli, D{\'e}sir{\'e}e and Petris, Maria Grazia and Rondelli, Roberto and Carraro, Francesca and Colombini, Antonella and Muggeo, Paola and Ziino, Ottavio and Melchionda, Fraia and Russo, Giovanna and Pierani, Paolo and Soncini, Elena and DeSantis, Raffaella and Zanazzo, Giulio and Barone, Angelica and Cesaro, Simone and Cellini, Monica and Mura, Rossella and Milano, Giuseppe M and Meazza, Cristina and Cicalese, Maria P and Tropia, Serena and De Masi, Salvatore and Castagnola, Elio and Aric{\`o}, Maurizio} } @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} } @article {1847, title = {Marriage and parenthood among childhood cancer survivors: a report from the Italian AIEOP Off-Therapy Registry.}, journal = {Haematologica}, volume = {96}, year = {2011}, month = {2011 May}, pages = {744-51}, abstract = {

BACKGROUND: The aim of this study was to describe the patterns of marriage and parenthood in a cohort of childhood cancer survivors included in the Off-Therapy Registry maintained by the Italian Association of Pediatric Hematology and Oncology.

DESIGN AND METHODS: We analyzed a cohort of 6,044 patients diagnosed with cancer between 1960 and 1998, while aged 0 to 14 years and who were 18 years old or older by December 2003. They were followed up through the regional vital statistics registers until death or the end of follow up (October 30, 2006), whichever occurred first, and their marital status and date of birth of their children were recorded. The cumulative probabilities of being married and having a first child were computed by gender and compared by tumor type within the cohort. Marriage and fertility rates (the latter defined as the number of live births per woman-year) were compared with those of the Italian population of the same age, gender, area of residence and calendar period by means of the observed to expected (O/E) ratios.

RESULTS: During the follow-up period, 4,633 (77\%) subjects had not married. The marriage O/E ratios were 0.56 (95\% CI: 0.51-0.61) and 0.70 (95\% CI: 0.65-0.76) among men and women, respectively. Overall, 263 men had 367 liveborn children, and 473 women had 697 liveborn children. The female fertility O/E ratio was 0.57 (95\% CI: 0.53-0.62) overall, and 1.08 (95\% CI: 0.99-1.17) when analyses were restricted to married/cohabiting women

CONCLUSIONS: Childhood cancer survivors are less likely to marry and to have children than the general population, confirming the life-long impact of their previous disease on their social behavior and choices. The inclusion of counseling in the strategies of management and long-term surveillance of childhood cancer patients could be beneficial to survivors as they approach adulthood.

}, keywords = {Adult, Child, Child, Preschool, Cohort Studies, Female, Follow-Up Studies, Hematologic Neoplasms, Humans, Infant, Infant, Newborn, Italy, Male, Marriage, Middle Aged, Parents, Registries, Survivors}, issn = {1592-8721}, doi = {10.3324/haematol.2010.036129}, author = {Pivetta, Emanuele and Maule, Milena M and Pisani, Paola and Zugna, Daniela and Haupt, Riccardo and Jankovic, Momcilo and Aric{\`o}, Maurizio and Casale, Fiorina and Clerico, Anna and Cordero di Montezemolo, Luca and Kiren, Valentina and Locatelli, Franco and Palumbo, Giovanna and Pession, Andrea and Pillon, Marta and Santoro, Nicola and Terenziani, Monica and Valsecchi, Maria Grazia and Dama, Elisa and Magnani, Corrado and Merletti, Franco and Pastore, Guido} } @article {1636, title = {Morbidity of pandemic H1N1 influenza in children with cancer.}, journal = {Pediatr Blood Cancer}, volume = {55}, year = {2010}, month = {2010 Aug}, pages = {226-8}, abstract = {

BACKGROUND: To define the mortality and the current impact of the H1N1 pandemic in pediatric hematology-oncology centers, we performed a specific survey.

PROCEDURE: Pharyngeal swabs from patients with fevers of unknown origin, flu-like symptoms or bronchopneumonia were screened for H1N1 using PCR.

RESULTS: Sixty-two patients with documented H1N1 infection were reported: 16 had recently stopped therapy, 2 were at the diagnosis stage, and 44 were receiving therapy. The clinical course was severe (requiring ICU admission) in only 1 patient, moderate (requiring hospital admission) in 38, and mild in the remaining 23 (37\%), treated as outpatients. While none of the patients died of H1N1-related complications, two patients died of progressive cancer; in all of the remaining cases, symptoms resolved within 11 days. The clinical course was complicated by respiratory distress or bronchopneumonia in 10 cases. Oseltamivir was given to 82\% of patients. Chemotherapy was temporarily withdrawn in 54\% of cases for a median time of 21 days (range, 4-43 days).

CONCLUSION: H1N1 infection in children with cancer was not reported as the cause of death in any case but resulted in reduced intensity of anti-cancer therapy.

}, keywords = {Adolescent, Antineoplastic Agents, Cause of Death, Child, Child, Preschool, Data Collection, Disease Outbreaks, Humans, Influenza A Virus, H1N1 Subtype, Influenza, Human, Leukemia, Lymphoma, Non-Hodgkin, Morbidity, Neoplasms, Treatment Outcome, Young Adult}, issn = {1545-5017}, doi = {10.1002/pbc.22619}, author = {Caselli, D{\'e}sir{\'e}e and Carraro, Francesca and Castagnola, Elio and Ziino, Ottavio and Frenos, Stefano and Milano, Giuseppe Maria and Livadiotti, Susanna and Cesaro, Simone and Marra, Nicoletta and Zanazzo, Giulio and Meazza, Cristina and Cellini, Monica and Aric{\`o}, Maurizio} } @article {1637, title = {Multidrug resistant Pseudomonas aeruginosa infection in children undergoing chemotherapy and hematopoietic stem cell transplantation.}, journal = {Haematologica}, volume = {95}, year = {2010}, month = {2010 Sep}, pages = {1612-5}, abstract = {

Pseudomonas aeruginosa is one leading gram-negative organism associated with nosocomial infections. Bacteremia is life-threatening in the immunocompromised host. Increasing frequency of multi-drug-resistant (MDRPA) strains is concerning. We started a retrospective survey in the pediatric hematology oncology Italian network. Between 2000 and 2008, 127 patients with Pseudomonas aeruginosa bacteremia were reported from 12 centers; 31.4\% of isolates were MDRPA. Death within 30 days of a positive blood culture occurred in 19.6\% (25/127) of total patients; in patients with MDRPA infection it occurred in 35.8\% (14/39). In the multivariate analysis, only MDRPA had significant association with infection-related death. This is the largest series of Pseudomonas aeruginosa bacteremia cases from pediatric hematology oncology centers. Monitoring local bacterial isolates epidemiology is mandatory and will allow empiric antibiotic therapy to be tailored to reduce fatalities.

}, keywords = {Adolescent, Antineoplastic Agents, Bacteremia, Child, Child, Preschool, Drug Resistance, Multiple, Female, Hematopoietic Stem Cell Transplantation, Humans, Immunocompromised Host, Infant, Infant, Newborn, Italy, Male, Pseudomonas aeruginosa, Pseudomonas Infections, Retrospective Studies, Young Adult}, issn = {1592-8721}, doi = {10.3324/haematol.2009.020867}, author = {Caselli, D{\'e}sir{\'e}e and Cesaro, Simone and Ziino, Ottavio and Zanazzo, Giulio and Manicone, Rosaria and Livadiotti, Susanna and Cellini, Monica and Frenos, Stefano and Milano, Giuseppe M and Cappelli, Barbara and Licciardello, Maria and Beretta, Chiara and Aric{\`o}, Maurizio and Castagnola, Elio} }