%0 Journal Article %J Pediatr Blood Cancer %D 2018 %T Multicenter randomized, double-blind controlled trial to evaluate the efficacy of laser therapy for the treatment of severe oral mucositis induced by chemotherapy in children: laMPO RCT. %A Gobbo, Margherita %A Verzegnassi, Federico %A Ronfani, Luca %A Zanon, Davide %A Melchionda, Fraia %A Bagattoni, Simone %A Majorana, Alessandra %A Bardellini, Elena %A Mura, Rosamaria %A Piras, Alessandra %A Petris, Maria Grazia %A Mariuzzi, Maria Livia %A Barone, Angelica %A Merigo, Elisabetta %A Decembrino, Nunzia %A Vitale, Marina Consuelo %A Berger, Massimo %A Defabianis, Patrizia %A Biasotto, Matteo %A Ottaviani, Giulia %A Zanazzo, Giulio Andrea %X

OBJECTIVES: To demonstrate the efficacy of laser photobiomodulation (PBM) compared to that of placebo on severe oral mucositis (OM) in pediatric oncology patients. The primary objective was the reduction of OM grade (World Health Organization [WHO] scale) 7 days after starting PBM. Secondary objectives were reduction of pain, analgesic consumption, and incidence of side effects.

METHODS: One hundred and one children with WHO grade > 2 chemotherapy-induced OM were enrolled in eight Italian hospitals. Patients were randomized to either PBM or sham treatment for four consecutive days (days +1 to +4). On days +4, +7, and +11, OM grade, pain (following a 0-10 numeric pain rating scale, NRS) and need for analgesics were evaluated by an operator blinded to treatment.

RESULTS: Fifty-one patients were allocated to the PBM group, and 50 were allocated to the sham group. In total, 93.7% of PBM patients and 72% of sham patients had OM grade < 3 WHO on day +7 (P = 0.01). A significant reduction of pain was registered on day +7 in the PBM versus sham group (NRS 1 [0-3] vs. 2.5 [1-5], P < 0.006). Reduced use of analgesics was reported in the PBM group, although it was not statistically significant. No significant adverse events attributable to treatment were recorded.

CONCLUSIONS: PBM is a safe, feasible, and effective treatment for children affected by chemotherapy-induced OM, as it accelerates mucosal recovery and reduces pain.

%B Pediatr Blood Cancer %V 65 %P e27098 %8 2018 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/29727048?dopt=Abstract %R 10.1002/pbc.27098 %0 Journal Article %J Biol Blood Marrow Transplant %D 2012 %T Allogeneic hematopoietic stem cell transplantation for Philadelphia-positive acute lymphoblastic leukemia in children and adolescents: a retrospective multicenter study of the Italian Association of Pediatric Hematology and Oncology (AIEOP). %A Fagioli, Franca %A Zecca, Marco %A Rognoni, Carla %A Lanino, Edoardo %A Balduzzi, Adriana %A Berger, Massimo %A Messina, Chiara %A Favre, Claudio %A Rabusin, Marco %A Lo Nigro, Luca %A Masetti, Riccardo %A Prete, Arcangelo %A Locatelli, Franco %K Adolescent %K Antineoplastic Combined Chemotherapy Protocols %K Benzamides %K Child %K Child, Preschool %K Disease-Free Survival %K Drug Administration Schedule %K Female %K Fusion Proteins, bcr-abl %K Graft vs Host Disease %K Hematopoietic Stem Cell Transplantation %K Humans %K Infant %K Italy %K Male %K Philadelphia Chromosome %K Piperazines %K Precursor Cell Lymphoblastic Leukemia-Lymphoma %K Pyrimidines %K Remission Induction %K Retrospective Studies %K Secondary Prevention %K Transplantation, Homologous %K Young Adult %X

Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) still represents a major challenge. We report the experience of the Italian Association of Pediatric Hematology and Oncology (AIEOP) with allogeneic hematopoietic stem cell transplantation (HSCT) in children with Ph+ ALL from 1990 to 2008. Sixty-nine patients received HSCT from either a related (37, 54%) or an unrelated (32, 46%) donor. Twenty-five patients (36%) underwent transplantation before 2000 and 44 (64%) after 2000. Twenty-three patients (33%) received Imatinib mesylate treatment before HSCT and seven (10%) after HSCT. After a median follow-up of 56 months, the overall survival (OS) probability was 51% (95% confidence interval [CI], 38-63), the leukemia-free survival (LFS) was 47% (95% CI, 34-59), transplantation-related mortality (TRM) was 17% (95% CI, 10-30), and relapse incidence (RI) was 36% (95% CI, 26-50). Transplantation in first complete remission, female gender, and lower WBC count at diagnosis were associated with a better LFS in both univariate and multivariate analyses. Patients with p210 transcript had a trend for a worse prognosis compared with those who had the p190 transcript. Our series confirms the role of HSCT in the eradication of Ph+ ALL. Early HSCT is recommended once morphologic remission is obtained.

%B Biol Blood Marrow Transplant %V 18 %P 852-60 %8 2012 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/22019726?dopt=Abstract %R 10.1016/j.bbmt.2011.10.015 %0 Journal Article %J Pediatr Blood Cancer %D 2010 %T Incidence of bacteremias and invasive mycoses in children with acute non-lymphoblastic leukemia: results from a multi-center Italian study. %A Castagnola, Elio %A Rossi, Mario R %A Cesaro, Simone %A Livadiotti, Susanna %A Giacchino, Mareva %A Zanazzo, Giulio %A Fioredda, Francesca %A Beretta, Chiara %A Ciocchello, Francesca %A Carli, Modesto %A Putti, Maria Caterina %A Pansini, Valeria %A Berger, Massimo %A Licciardello, Maria %A Farina, Silvia %A Caviglia, Ilaria %A Haupt, Riccardo %K Antineoplastic Combined Chemotherapy Protocols %K Bacteremia %K Child %K Female %K Follow-Up Studies %K Humans %K Incidence %K Italy %K Leukemia, Myeloid, Acute %K Male %K Mycoses %K Neoplasm Recurrence, Local %K Retrospective Studies %X

BACKGROUND: Data on the epidemiology of bacteremias and invasive fungal diseases (IFD) in children with acute myeloid leukemia (AML) are scarce.

DESIGN AND METHODS: In a multi-center, retrospective study, we analyzed proportion, rate per 1,000 person-days at risk, and cumulative risk of bacteremias and IFD in children with AML.

RESULTS: Between January 1998 and December 2005, 240 children were treated for AML at 8 Italian Centers, for a total of 521 treatment courses and 63,232 person-days at risk. Bacteremia was observed in 32% of treatment courses and IFD was seen in 10% (P < 0.0001), with rates of 2.62 and 0.84, respectively (P < 0.001). There was a significantly higher frequency of IFD during relapse treatment: proportion 15% versus 9% (P = 0.05), rate 2.10 versus 0.64 (P = 0.008) and cumulative risk 32% versus 12% (P = 0.007), while there were no differences in the proportion, rate and cumulative risk of bacteremia during front-line or relapse treatment. The epidemiology of bacteremias and IFD was different during front-line therapy for M3 as compared to other types of AML, but the differences were not statistically significant.

CONCLUSIONS: Severe infectious complications are frequent during the treatment of pediatric AML, especially during relapse treatment, and bacteremias are more frequent than IFD.

%B Pediatr Blood Cancer %V 55 %P 1103-7 %8 2010 Dec 1 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/20680968?dopt=Abstract %R 10.1002/pbc.22750