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ABSTRACT: Imatinib mesylate (IM), a BCR-ABL tyrosine kinase inhibitor (TKI), is the standard treatment for patients with chronic myeloid leukemia (CML). However, the inhibition in normal cells of two additional targets of IM, platelet-derived growth factor receptor and c-KIT, may be associated with side effects. We followed 4 pre-pubertal CML patients (3 males, 1 female) on prolonged treatment with IM to evaluate growth, pubertal development and bone metabolism. An increase in C-terminal telopeptides of type I collagen, marker of bone resorption, was observed in all patients and a decrease of bone mineral density was recorded in two boys. The growth rate showed a delay in height, which recovered over time in all patients. IM therapy may result in a decelerated growth and a dysregulated bone remodeling in pre-pubertal patients. Bone metabolism and growth velocity should be closely monitored in children treated with TKIs, in order to plan the optimal treatment strategy.
Haematologica 09/2012; · 6.42 Impact Factor
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ABSTRACT: An adapted LMB 96 derived protocol for B-cell non-Hodgkin lymphoma (NHL) was implemented at the pediatric oncology unit of the Children Welfare Teaching Hospital in Baghdad (Iraq) from 2000 to present. The purpose was to evaluate the feasibility and efficacy of this intensive therapeutic regimen in a limited resource country.
Patients <15 years of age with high grade B-cell NHL were included. A modified LMB 96 regimen was employed with a reduction of cyclophosphamide and methotrexate dosages due to inadequate laboratory facilities and supportive care.
Between 2000 and 2005, 261 children with non-lymphoblastic NHL were registered; 239 were eligible for the analysis. Two patients had stage I disease, 20 stage II, 179 stage III, and 38 stage IV. Fifty-two patients (22%) had bulky disease. Twelve children were assigned to therapeutic group A (low risk), 184 to group B (intermediate risk), and 43 to group C (high risk). One hundred and eighty-four patients (77%) had a complete response after the COP pre-phase. Sixty-nine patients (29%) died during treatment. Twenty-nine patients abandoned treatment. At 24 months, the overall survival rate of the entire patient population was 66% (CI 95%: 62.2-70.6) and the event-free survival rate 53.3% (CI 95%: 50.0-56.8).
The treatment schedule proved effective, but the treatment-related mortality due to infections and metabolic complications was very high owing to the limited supportive care available. The high rate of treatment abandonment was also an important cause of failure, especially for children living far away from the hospital.
Pediatric Blood & Cancer 04/2011; 56(4):560-7. · 1.89 Impact Factor
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Corrado Girmenia,
Caterina Mercanti,
Vincenzo Federico,
Massimiliano Rea, Annalisa De Vellis,
Veronica Valle,
Alessandra Micozzi,
Roberto Latagliata,
Massimo Breccia,
Salvatore Giacomo Morano,
Gregorio Antonio Brunetti,
Michela Sali,
Giovanni Delogu,
Robin Foà,
Giuliana Alimena,
Giuseppe Gentile
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ABSTRACT: Data derived from epidemiologic surveillance adopted at our center in hematologic and stem cell transplant patients during the 2009 influenza A (H1N1)v pandemic are reported. Of the 52 patients with influenza-like disease we observed, 37 underwent a real-time PCR evaluation and 21 had a confirmed diagnosis. Of the RT-PCR-confirmed cases, 23.8% were children (age <18 years) and 9.5% were >65 years; 47.6% presented with a pulmonary infiltrate and 33.3% with respiratory failure. Pulmonary involvement was observed more frequently in patients with comorbidities. All patients received a course of oseltamivir therapy starting an average of 1 day (range <1-2) after the onset of symptoms. No patient was transferred to the intensive care unit. The viral disease had a generally favorable outcome despite the high frequency of pulmonary involvement. A prompt clinical evaluation with an early antiviral and supportive therapy may have played a beneficial role in the outcome.
Acta Haematologica 03/2011; 126(1):1-7. · 1.35 Impact Factor
