Giuseppe Masera

• MD, FRCP
• ASST Monza – San Gerardo Hospital

The aim of this paper is to show the educational objectives and the implementation modalities of the paediatric course of the University of Milan-Bicocca School of Medicine, based in Monza. The course takes place during the fifth and sixth year and involves university, hospital and local figures in the training of a non-specialist doctor, according...

Leukemia accepted article preview online, 27 April 2017. doi:10.1038/leu.2017.127.

Background: Moebius syndrome (MBS) is rare disease characterized by nonprogressive congenital uni- or bi-lateral facial (i. e. VII cranial nerve) and abducens (i. e. VI cranial nerve) palsy. Although the neurological and ophthalmological findings are quite well-known, data concerning the attendant functional difficulties and their changes over tim...

During the last few years, the term resilience has become popular in common language and public discourse within a variety of domains, from psychology to medicine, from economics to ecology. However, its meaning is often misunderstood and generalized as an unspecific tendency to resist life upheavals and problems. Through theoretical models and emp...

In Paraguay, cancer is among the leading causes of death among children. We report challenges and solutions for building the country's first pediatric cancer center at the National University School of Medicine (PCC-SM) and describe the outcomes of the National Network for Pediatric Cancer. We found that children with acute lymphoblastic leukemia t...

Williams-Beuren syndrome (WBS) is a genetic disorder that involves elastin gene causing cardiovascular abnormalities and increased risk. However, data on arterial function in these patients are only few and conflicting. Aim of this study was to evaluate dynamic behaviour of central and peripheral blood pressure (BP) and arterial stiffness parameter...

In order to quantify the association between use of statins and the risk of all hematological malignancies and of subtypes, we performed a meta-analysis of observational studies. We achieved a MEDLINE/EMBASE comprehensive search for studies published up to August 2014 investigating the association between use of statins and the risk of hematologica...

Background: Aetiology of childhood leukaemia and childhood neoplasm is poorly understood. Information on the prevalence of risk factors in the childhood population is limited. SETIL is a population based case-control study on childhood leukaemia, conducted with two companion studies on non-Hodgkin Lymphoma (NHL) and neuroblastoma. The study relies...

Background: Parental smoking and exposure of the mother or the child to environmental tobacco smoke (ETS) as risk factors for Acute non-Lymphocytic Leukemia (AnLL) were investigated. Methods: Incident cases of childhood AnLL were enrolled in 14 Italian Regions during 1998-2001. We estimated odds ratios (OR) and 95% confidence intervals (95%CI) c...

Childhood cancer survival rates in highly developed countries have risen remarkably over the past 50 years from <10 % to over 80 %. This has been achieved as a result of early and precise diagnosis, effective and targeted treatment, and adequate supportive care. This contrasts with the situation in low- and middle-income countries (LMICs) where ove...

Abstract This study investigated memories of childhood leukemia conveyed by survivors belonging to a Latin culture, exploring whether benefit findings was spontaneously reported, as by non-Latin survivors. Three hundred patients previously treated for leukemia were contacted by post/e-mail and asked to write freely about their illness experience. T...

Background Separating out the effects of cancer and treatment between central and peripheral components of the O2 delivery chain should be of interest to clinicians for longitudinal evaluation of potential functional impairment in order to set appropriate individually tailored training/rehabilitation programmes. We propose a non-invasive method (NI...

The aim of this paper is to describe the results of acute lymphoblastic leukemia (ALL) treatment in Nicaragua from 1995 to 2005 in the context of an international cooperation program. Patients <18 years with ALL were treated with two consecutive protocols (1995 and 2000). After a steroid prophase, a three-drug induction was administered in protocol...

Five Asociación de Hemato-Oncología de Centroamérica (AHOPCA) countries have used an adapted BFM-based protocol for childhood acute lymphoblastic leukemia (ALL). In the AHOPCA-ALL 2008 protocol, patients were stratified by age, white blood cell count, immunophenotype, central nervous system involvement, day 8 prednisone response, and morphologic bo...

Bridging the survival gap for children with cancer, between those (the great majority) in low and middle income countries (LMIC) and their economically advantaged counterparts, is a challenge that has been addressed by twinning institutions in high income countries with centers in LMIC. The long-established partnership between a Central American co...

Key Points Intensive BFM therapy is effective for HR childhood ALL if low MRD levels are achieved at the end of the induction/consolidation phase. Childhood ALL with high MRD levels at the end of induction/consolidation phase has a poor prognosis despite intensive BFM therapy or HSCT.

From 2002 to 2007, the International Berlin-Frankfurt-Münster Study Group conducted a prospective randomized clinical trial (ALL IC-BFM 2002) for the management of childhood acute lymphoblastic leukemia (ALL) in 15 countries on three continents. The aim of this trial was to explore the impact of differential delayed intensification (DI) on outcome...

Objectives Leukaemia is the most common cancer in children, but its aetiology is still poorly understood. We tested the hypothesis that traffic-related air pollution is associated with paediatric leukaemia because of chronic exposure to several potential carcinogens. Methods The Italian SETIL study (Study on the aetiology of lymphohematopoietic mal...

Thalassemia major (TM) is the most frequent life-threatening noninfectious disease of childhood in the Middle East, South Asia, and Pacific Islands where it accounts for a significant proportion of childhood mortality, morbidity, and related health care expenses. In spite of major advances in supportive care during the last decade, many patients in...

Approximately 10–15% of pediatric patients with acute lymphoblastic leukemia (ALL) have a T-cell phenotype. The prognosis of these patients has improved over the last years, owing to the use of more intensive treatment strategies. Characterization of molecular alterations with prognostic impact in T-ALL may be of great help for an early identificat...

Introduction: Venous thromboembolic events (VTEs) are frequent complications of childhood acute lymphoblastic leukemia (ALL) treatment. The aim of the study was to evaluate the rate of symptomatic VTEs in children with ALL and the predictive value of clinical and biological factors and routine monitoring of coagulation parameters in identifying ch...

2496 Cases of childhood leukemia very rarely present as a significant time/space cluster. Clusters offer a unique opportunity to identify a point source causal exposure but, in practice, this is extremely difficult. We herewith report an apparent cluster of seven cases of childhood B cell precursor acute lymphoblastic leukaemia (ALL) occurring over...

Background. The event-free survival for pediatric leukemia in low-income Countries is much lower than in high-income countries. Late diagnosis, which is regarded as a contributing factor, may be due to "parental" or "medical" delay. Procedures. The present study analyses determinants of lag time from first symptoms to diagnosis of leukemia, compari...

The available guidelines for varicella vaccination of susceptible children with acute lymphoblastic leukemia (ALL) have become increasingly conservative. However, vaccination of those who have remained in continuous complete remission for 1 year and are receiving chemotherapy is still considered a reasonable option. There is little available data t...

872 Introduction ALL IC-BFM 2002 is one of the most successful projects developed by the I-BFM-SG, which is one of the world largest societies involving national leukemia groups. The trial evaluated in a randomized manner the impact on outcome of intensified late reinduction in the context of a newly developed risk stratification. The main goal of...

Deferiprone is an effective oral iron chelator which plays a particularly important role in the removal of cardiac iron burden in thalassaemic patients with transfusional iron overload1–5. Agranulocytosis, of uncertain pathogenesis, is its most important and severe side effect, reported in less than 2% of cases. Only a few such cases have so far be...

Endocrine complications in Β-thalassemia represent a prominent cause of morbidity. Above all, dysfunction of GH-IGF-1 axis is of a major concern because of its pathogenic role on cardiac and bone disease, frequently described in this clinical setting. The aim of this paper is to analyze GH-IGF-1 axis in a cohort of 25 adult patients affected by Β-t...

Modern treatment of childhood acute leukemias started with the use of methotrexate (MTX) by Farber and colleagues in 1948 (reviewed in Dawn of Chemotherapy of Childhood Cancer) (Wolff 1999). The first observations of risk categorizations came in 1949 when Wolf Zuelzer noted that in patients treated with supportive care alone, those with initial whi...

Background/Purpose Remarkable advances in paediatric cancer research and treatment were achieved during the last decades: In industrialised nations, overall cure rates were raised from below 20% to over 75% during the last forty years. Randomised investigator-driven clinical trials have been the backbone of this progress so far. The EU Clinical Tri...

Background Although cure rates for childhood cancer have improved from below 20% to more than 75% during the last 40 years, childhood cancer is still the number one killer amongst paediatric diseases. European paediatric cancer research also faces new challenges by the increasing number of childhood cancer survivors, some of whom experience signifi...

[This corrects the article on p. 63 in vol. 8, PMID: 20104280.].

We report the case of a 22-year-old woman from Albania, with thalassaemia major, in severe clinical condition who could no longer be transfused due to the occurrence of severe, acute, post-transfusional reactions. After 10 years of treatment, she failed to respond to hydroxyurea. When she received thalidomide, haemoglobin levels increased from 3.7...

Leukemia is one of the leading journals in hematology and oncology. It is published monthly and covers all aspects of the research and treatment of leukemia and allied diseases. Studies of normal hemopoiesis are covered because of their comparative relevance.

Expert witnesses: the reasons for a project Objectives Since march 2007 in the Onco-Haematology Paediatric Centre of the San Gerardo di Monza Hospital the project "Expert witnesses" is active. The aim of the project is to make families able to manage oncological diseases through structured encounters between parents of sick children and other child...

We analyzed the long-term outcome of 4865 patients treated in Studies 82, 87, 88, 91 and 95 for childhood acute lymphoblastic leukemia (ALL) of the Italian Association of Pediatric Hematology and Oncology (AIEOP). Treatment was characterized by progressive intensification of systemic therapy and reduction of cranial radiotherapy. A progressive impr...

1578 Poster Board I-604 Background T-ALL accounts for about 15% of pediatric ALL and still represents a clinical challenge, because more than 20% of children experience a recurrent disease which has a dismal prognosis. Characterization of molecular alterations with prognostic impact may be useful for an early identification of patients at high ris...

319 Aim The Italian Association of Pediatric Haematology and Oncology (AIEOP) patients, diagnosed in the period September 2000-July 2006, were treated in the context of the AIEOP-BFM ALL 2000 Study. Some differences in high risk (HR) treatment and hematopoietic stem cell transplantation (HSCT) indications justify separate reporting of results obta...

An international childhood acute lymphoblastic leukemia (ALL)working group was formed during the 27th annual meeting of the International Society of Pediatric Oncology in 1995. Since then, 10 workshops have been held to address many issues that help advance treatment outcome of childhood ALL but require international collaboration (Table 1). The gr...

Speed of blast clearance is an indicator of outcome in childhood acute lymphoblastic leukemia (ALL). Availability of measurement of minimal residual disease (MRD) at an early time point with a reduced-cost method is of clinical relevance. In the AIEOP-BFM-ALL (Associazione Italiana Ematologia Oncologia Pediatrica and Berlin-Frankfurt-Münster Study...

Immunity to tetanus toxoid and polioviruses was studied in 34 (27 allografted, 7 autografted) children who underwent bone marrow transplantation (BMT). At a median time of 3 years after BMT, only one recipient was seronegative for tetanus toxoid. On the contrary 73% of children were seronegative for at least one of the three poliovirus types and 30...

Five paediatric patients with a myelodysplastic syndrome (MDS) (age range 4–12 years) are described. The frequency of MDS in our institution in the last 13 years is 1.12% of all leukaemic syndromes. Diagnosis and classification were made according to the recent proposals of the FAB Co-operative Group: four refractory anaemia with excess of blasts i...

Eight children with previously untreated ANLL received an induction regimen consisting of daunomycin and ara-C. All patients achieved complete remission. Post-remission chemotherapy was ara-C 3 g/m2 given i.v. over 3 h, at 12-h intervals, for four doses, and L-asparaginase 6000 IU/m2 i.m. 3 h after the fourth infusion of ara-C; four cycles were giv...

This paper reports the results of a multicentric randomized clinical trial on the treatment of first hematological relapse in childhood ALL. Induction treatment consisted of vincristine, adriamycin, L-asparaginase, and prednisone. Patients achieving complete remission were randomized to two maintenance regimens (A and B). Regimen A consisted of fiv...

Nineteen children with acute lymphoblastic leukemia (ALL) and 11 with acute non-lymphoblastic leukemia (ANLL) in first or subsequent hematological relapse, and previously exposed to high doses of anthracyclines, were treated with Epirubicin. Eleven patients (7 ANLL and 4 ALL) were treated with Epirubicin as a single drug at the dose of 30 mg/m2/day...

The occurrence of liver disease and its relation to HBV markers were investigated in ten children with AML who were given HDARAC as late consolidation therapy. None of them developed jaundice or biochemical evidence of cholestasis. During therapy, SGPT values were normal in 5/10 patients, while in the other 5 a sharp increase was noted. These enzym...

Since its foundation in 1991, the SIOP Working Committee on Psychosocial Issues in Paediatric Oncology1 has developed and published 12 sets of Guidelines for health-care professionals treating children with cancer and their families. Those elements considered essential in the process of cure and care of children with cancer are summarized in this d...

In den letzten Jahren ist die Anzahl von Patienten, die erfolgreich wegen einer Krebserkrankung im Kindesalter behandelt wurden, stetig angestiegen. Mitglieder des Früh- und Spättoxizitäts- sowie Ausbildungskomitees der internationalen Berlin-Frankfurt-Münster Studien-Gruppe (I-BFM-SG-ELTEC) haben 45 pädiatrische Krebsspezialisten (Onkologen, Psych...

Survival of adolescents (15-19 years old) with cancer has shown less favourable improvement in comparison with survival rates for younger children and older adults. This might be partly explained by the relative lack of participation of adolescents in cooperative clinical protocols. This analysis compares the number of 15- to 19-year-olds treated a...

Introduction: The International “Berlin-Frankfurt-Münster” Study Group (I-BFM-SG) pioneered the evaluation of minimal residual disease (MRD) based on Immunoglobulin and T-cell Receptor gene rearrangements as PCR targets. The prospective AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica)-BFM ALL 2000 study is the largest in which standard...

Posterior reversible leukoencephalopathy (PRES) is a clinical-radiological event that can affect children undergoing chemotherapy regimen. Studies have shown that it is not always reversible, in spite of its original definition. We analyzed PRES cases which occurred during the last 10 years at our institute to focus on their clinical, radiological...

Background: Children with asthma and oncohematologic illnesses are among those considered at risk for severe complications from influenza and for whom influenza vaccination is recommended annually. This study was planned to evaluate the impact of ILI in children with asthma and with oncohematologic diseases in comparison with healthy controls. Meth...

The main psychosocial purpose in treating childhood cancer is to help children and their families to face the diagnosis of cancer and subsequent consequences. Children and their families, most of whose are in front of this new diagnosis without showing any sign of failure, need our help. We should try from one side to help the child and his/her fam...

Detection of minimal residual disease (MRD) is the most sensitive method to evaluate treatment response and one of the strongest predictors of outcome in childhood acute lymphoblastic leukemia (ALL). The 10-year update on the I-BFM-SG MRD study 91 demonstrates stable results (event-free survival), that is, standard risk group (MRD-SR) 93%, intermed...

About the 11–14% of patients with thalassemia major (TM) treated with deferasirox (DFO) develops retinopathy and/or lens opacities with an unclear pathogenesis but with a clear age related pattern.[1][1],[2][2] Possible causes can be either iron overload itself or DFO toxicity, with various

Between May 1995 and August 2000 the Associazione Italiana di Ematologia Oncologia Pediatrica conducted the ALL-95 study for risk-directed, Berlin-Frankfurt-Muenster (BFM) -oriented therapy of childhood acute lymphoblastic leukemia, aimed at exploring treatment reduction in standard-risk patients (SR) and intensification during continuation therapy...

We performed an 11 year retrospective study on 34 sickle-cell paediatric patients, focusing on efficacy, safety and costs of an exchange transfusion program in 13 high risk patients. A good clinical control with improvement in patients' quality of life, no disease related complications, no significant iron overload and no procedure related side eff...

We report the results of a protocol for the diagnosis and treatment of pediatric non-Hodgkin lymphomas (NHL) conducted in Nicaragua in the context of an international collaborative program. Fifty-three children with NHL treated between 1996 and 2003 were retrospectively evaluated. Therapy was designed based on local drug availability and affordabil...

We compared the clinical and biologic features and treatment results of patients with DS-ALL (n=120, 1.9%), compared to those without DS (n=6237), enrolled in the AIEOP trials between 1988 and October 2004. DS patients had significantly more often the following characteristics: female gender (55.0% vs 44.9%, p=0.027), age 10 years or older (28.3 vs...

Minimal residual disease (MRD), the most sensitive method to evaluate treatment response, has been adopted to stratify patients in study AIEOP-BFM ALL 2000. To assess whether PCR-MRD levels discriminate outcome in patients classified by WBC count, age at diagnosis, NCI criteria (Standard Risk, SR: WBC < 50,000/cmm and age 1–9 years; High Risk, HR:...

Between May 1995 and August 2000 the Associazione Italiana di Ematologia Oncologia Pediatrica (AIEOP) conducted the ALL-95 study for risk-directed, BFM-oriented therapy of childhood acute lymphoblastic leukemia (ALL), aimed at exploring treatment reduction in standard risk (SR) and intensification during continuation therapy in intermediate risk (I...

Early measurement of blast clearance is a relevant prognostic indicator in childhood acute lymphoblastic leukemia (ALL). To this purpose we measured, by four-colour flowcytometry (FC), the percentage of blast cells in bone marrow samples from Italian patients enrolled in the multicentre AIEOP-BFM ALL 2000 trial. Samples were collected on day 15 (af...

Epidemiological monitoring of diseases: a pilot study in eight Italian hospitals The paper reports the activity of an epidemiological surveillance network in eight hospitals in the Lombardia Region, Italy. 235 cases of 15 monitored diseases were reported in two years (148 during 2005 and 87 during 2006). Schönlein-Henoch purpura was the most common...