Momcilo Jankovic

• Università degli Studi di Milano-Bicocca

Background Childhood cancer survivors are at risk of subsequent gliomas and meningiomas, but the risks beyond age 40 years are uncertain. We quantified these risks in the largest ever cohort. Methods Using data from 69,460 5-year childhood cancer survivors (diagnosed 1940–2008), across Europe, standardized incidence ratios (SIRs) and cumulative in...

Purpose: Radiation to the bone and exposure to alkylating agents increases the risk of bone cancer among survivors of childhood cancer, but there is uncertainty regarding the risks of bone tissue radiation doses below 10 Gy and the dose-response relationship for specific types of chemotherapy. Methods: Twelve European countries contributed 228 c...

Severe acute behavioral and emotional problems represent one of the most serious treatment-related adverse effects for children and adolescents who have cancer. The critical and severe nature of these symptoms often makes necessary the use of psychotropic drugs. A working group composed of experts in multiple disciplines had the task of creating an...

Background Survivors of Hodgkin lymphoma (HL) are at risk of developing non‐Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent primary lymphomas (SPLs), including HL and NHL, after different types of childhood cancer are unknown. The authors quantified the risk of SPLs using the largest cohort of childhood cancer su...

Background Survivors of childhood cancer are at risk of subsequent primary malignant neoplasms (SPNs), but the risk for rarer types of SPNs, such as oral cancer, is uncertain. Previous studies included few oral SPNs, hence large-scale cohorts are required to identify groups at risk s . Methods The PanCareSurFup cohort includes 69,460 5-year surviv...

PURPOSE Heart failure (HF) is a potentially life-threatening complication of treatment for childhood cancer. We evaluated the risk and risk factors for HF in a large European study of long-term survivors. Little is known of the effects of low doses of treatment, which is needed to improve current treatment protocols and surveillance guidelines. ME...

During cancer treatments in childhood hematological malignancies, reduced exercise tolerance is one of the main hardships. Precision-based training programs help children, adolescents, and young adults and their families to resume regular physical activity, exercise, and sports once they return to their communities after the intensive phases spent...

Children: adolescents, and young who are adults affected with hematological malignancies (CAYA-H) and who are undergoing intensive phases of cancer treatment, including hematopoietic stem cell transplantation (HSCT), experience diminished functional ability. This study was aimed at assessing the feasibility, efficacy, safety, and satisfaction of an...

Late mortality of European 5‐year survivors of childhood or adolescent cancer has dropped over the last 60 years, but excess mortality persists. There is little information concerning secular trends in cause‐specific mortality among older European survivors. PanCareSurFup pooled data from 12 cancer registries and clinics in 11 European countries fr...

AIM To evaluate the cumulative prevalence of coeliac disease, systemic lupus erythematosus, autoimmune hyperthyroidism and primary immunodeficiencies in children with either newly diagnosed/persistent or chronic immune thrombocytopenia (ITP). METHODS Monocentric retrospective analysis of the clinical and biochemical features of 330 consecutive pat...

Objective In this report, we determine the cumulative incidence of symptomatic cardiac ischaemia and its risk factors among European 5-year childhood cancer survivors (CCS) participating in the PanCareSurFup study. Methods Eight data providers (France, Hungary, Italy (two cohorts), the Netherlands, Slovenia, Switzerland and the UK) participating i...

Children and adolescents with haematological malignancies (PedHM) are characterized by a severe loss of exercise ability during cancer treatment, lasting throughout their lives once healed and impacting their social inclusion prospects. The investigation of the effect of a precision-based exercise program on the connections between systems of the b...

The present study focuses on the relation between coping strategies of children with leukemia during treatment and locus of control of their mothers. In particular, the study aims to determine whether maternal locus of control can influence sick children’s coping styles, and if this relation can be used to predict maladjustments. The study analyzed...

Pain management is a growing concern in pediatric cancer patients as pain can originate from multiple sources and negatively influence long-term children well-being. To gain a better understanding of the pain adjustment processes occurring in these young patients, here we have analyzed a cohort of 30 children and early adolescents with acute leukem...

Luigi Reale was not included as an author in the published article. Furthermore, in the original article, there was an error. A correction has beenmade toMethods, Patients and Study Methodology, first sentence of the section. “The study was performed in Italy between September and December 2016” should read as “This pediatric study was performed in...

Objective: Primary immune thrombocytopenia (ITP) is a hemorrhagic disorder. Spontaneous recovery within 12 months occurs in the majority of pediatric patients. Nevertheless, in 20–30% of children the disease is chronic. The impact extends to the patients' families, whose everyday life, in terms of interpersonal relationships and financial status, i...

Introduction Advances in paediatric oncology led to the increase in long-term survival, revealing the burden of therapy-related long-term side effects. We evaluated overall and cause-specific mortality in a large cohort of Italian childhood cancer survivors (CCSs) and adolescent cancer survivors identified through the off-therapy registry. Materia...

Purpose: The number of persons who have successfully completed treatment for a cancer diagnosed during childhood and who have entered adulthood is increasing over time, and former patients will become aging citizens. Methods: Ten years ago, an expert panel met in Erice, Italy, to produce a set of principles concerning the cure and care of surviv...

Introduction: We investigate the risks of subsequent primary bone cancers after childhood and adolescent cancer in 12 European countries. For the first time, we satisfactorily address the risks beyond 40 years from diagnosis and beyond 40 years of age among all survivors. Methods: This largest-ever assembled cohort comprises 69 460 five-year sur...

Background: Childhood cancer survivors are at risk of subsequent primary soft-tissue sarcomas (STS), but the risks of specific STS histological subtypes are unknown. We quantified the risk of STS histological subtypes after specific types of childhood cancer. Methods: We pooled data from 13 European cohorts, yielding a cohort of 69 460 five-year...

La presa in carico in onco-ematologia pediatrica comporta un’attenta analisi dei vari sintomi, legati sia alla malattia che ai trattamenti, ma anche dei vissuti del bambino che possono inficiare l’autostima, limitare le autonomie e modificare la percezione delle relazioni significative dentro il gruppo famiglia. L’obiettivo di questo studio, è stat...

Lo scopo principale di questo studio è stato quello di indagare la sfera emotiva e comportamentale del dolore in oncologia pediatrica. Lo studio, di tipo osservazionale e multicentrico è stato svolto in tre Day Hospital: U.O di Pediatria di Trento e Rovereto ed il DH della Clinica Pediatrica del San Gerardo di Monza. Ha coinvolto 50 bambini (7-14 a...

As we know, pain is a multifaceted issue and a challenging concern in pediatric patients with hematological malignancies. The study focused on the aspects related to the processes to face pain during the phases of treatment. The results highlight the importance to better identify particular treatment phases and lead to better adjustment to youth wh...

Background and aim: Childhood cancer survivors are at high risk of long-term adverse effects of cancer and its treatment, including cardiac events. The pan-European PanCareSurFup study determined the incidence and risk factors for cardiac events among childhood cancer survivors. The aim of this article is to describe the methodology of the cardiac...

Data collection form chemotherapy. (DOC)

Since 1972, children affected by cancer took advantage from multi-centric diagnostic and therapeutic protocols produced by the Italian Association of paediatric haematology and oncology (AIEOP). At the beginning, these protocols were used in few well-trained centres, later in almost all Italian haemato-oncological centres. The need of a careful mon...

Purpose: Few studies have addressed the adaptive mental health status of young adult (YA) survivors of childhood cancer (SCCs) and the siblings (SIBs) of the same families. This article explores the existence of different psychological well-being (PWB) profiles and verifies their relationship with life satisfaction, resilience, and mental adjustme...

This study aims to present the ways that children and adolescents with acute leukemia cope with pain. We have found that children in an active phase (induction, consolidation, re-induction) used less overall coping strategies than those children who are in the maintenance phase. The defence mechanisms (like a better family support perception) are i...

Introduction: Spirituality is a fundamental aspect of the psychological well-being of adolescents with cancer. This study reports on a survey conducted at pediatric oncology centers in Italy and Spain to examine the situation concerning the provision of spiritual support. Methods: An ad hoc questionnaire was distributed including multiple-choice...

Introduction: Adolescents with cancer often experience a longer diagnostic delay than children, mainly because they take longer to go to a doctor. The Italian Society for Adolescents with Oncohematological Diseases (SIAMO) has launched an information campaign focusing on raising adolescents' awareness of the importance of diagnosing cancer early....

This analysis compared the numbers of patients treated at Italian pediatric oncology group (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP]) centers with the numbers of cases predicted according to the population-based registry. It considered 32,431 patients registered in the AIEOP database (1989-2012). The ratio of observed (O) to ex...

Cornelia de Lange Syndrome (CdLS) is a rare genetic disorder caused by mutations in the cohesion complex and its regulators. The syndrome is characterized by multiple organ system abnormalities, pre- and post-natal growth retardation and typical facial features. Thrombocytopenia is a reduction in platelet count to <150 × 10(9) L. It can be caused b...

Acute lymphoblastic leukemia (ALL) is a very distressing experience for children and requires a special effort of adjustment. Therefore, it seems to be crucial to explore coping resources for the experienced risk condition. In this sense, the study focuses on coping strategies and locus of control in children with ALL during the treatment phase, an...

Background Fertility is impaired in many survivors of childhood cancer following treatment. Preservation of fertility after cancer has become a central survivorship concern. Nevertheless, several doctors, patients, and families do not discuss fertility and recommendations for fertility preservation in pediatrics are still lacking. Recommendations b...

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: The ITP-QoL is a disease-specific questionnaire for the assessment of health-related quality of life (HRQoL) in children with immune thrombocytopenia (ITP) and their parents. The aim of this study was to test the psychometric characteristics of the ITP-QoL in the Italian pediatric population in terms of validity and reliability. Proce...

Berlin-Frankfurt-Munster (BFM) and Dana-Farber Cancer Institute (DFCI) consortia's treatment strategies for acute lymphoblastic leukaemia (ALL) in children are widely used. We compared the health effects and monetary costs of hospital treatments for these two strategies. Parents of children treated at seven centres in Canada, Italy and the USA comp...

If you stop and think for a while, it’s easy to understand how the word “death” is usually far from the word “child”. How can the pediatric palliative care operators focus their attention on the quality of life? On which values is palliative medicine based? The issues that have arisen from the interviews in this qualitative research are different b...

Viene data ai lettori una chiave d’interpretazione, la più corretta e idonea, di una patologia relativamente frequente in età pediatrica, da non considerare grave ma fastidiosa, perché spesso ci si deve convivere. Passo dopo passo, attraverso dati scientifici e osservazioni personali, si vuole cer care di rendere tale patologia più accettata dal ba...

Purpose: It has long been recognised that effective cancer care is not possible without multi-professional team working. Collaboration and multi-professional working however are known to be less than straightforward. This project aimed to use a collaborative approach to explore and facilitate professional groups to work together more effectively i...

Internalizing problems, anxiety, depression, withdrawal, and consequent social problems are frequently observed in children with brain tumors. The objective of this work is to describe the relationship between these psychological problems and the type of parent-child communication established about the disease. A group of 64 children surviving a br...

The second of a series of papers dedicated to paediatric palliative care. The Authors describe their own experience with children with hematologic neoplasms in the regional context of Lumbardy, Italy. A home care model already realized and supported by a regional legislation is suggested.

We describe a case of precocious puberty in a girl treated with chemoradiotherapy according to the Italian Association of Pediatric Hematology and Oncology ALL 9503 protocol for acute lymphoblastic leukemia (ALL) from the age of 15 months until the age of 3 years and 4 months. The patient was treated with chemotherapy and cranial irradiation (18 Gy...

2214 Bernard-Soulier syndrome (BSS) has been historically described as an autosomal recessive disease, and more than 50 different mutations have been identified in homozygous or double-heterozygous patients. However, a few reports have suggested that BSS may be occasionally transmitted in an autosomal-dominant fashion. In 2001, we described six Ita...

Because of the life-altering and potentially lingering psychosocial effects of leukemia on children and families, pediatric health professionals have developed a variety of interventions to mitigate family distress. Psychosocial health services are psychological and social services and interventions that enable patients, their families, and health...

Bernard-Soulier syndrome is a very rare form of inherited thrombocytopenia that derives from mutations in GPIbα, GPIbβ, or GPIX and is typically inherited as a recessive disease. However, some years ago it was shown that the monoallelic c.515C>T transition in the GPIBA gene (Bolzano mutation) was responsible for macrothrombocytopenia in a few Itali...

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. We analyzed a cohort of 6,044 patients diagnosed with cancer between 1960 and 1998, while aged 0 to 14 years and who...

The eradication of Helicobacter pylori has been associated with remission of immune thrombocytopenia (ITP) in approximately half of eradicated patients. Data on children are limited to small case series. Children from 16 centers in Italy, who were less than 18 years of age and diagnosed with chronic ITP (cITP), were screened for H. pylori infection...

High dosage anthracyclines in pediatric patients with acute lymphoblastic leukemia (ALL) is associated with cardiotoxicity. However, data on the cardiac effects of lower cumulative doses of these drugs are not conclusive. The aim of this study was to assess the cardiac effects of low cumulative anthracycline doses in long-term survivors of ALL. Ech...

In order to verify whether a telephone recall system directly managed by the pediatricians who usually follow up the children for their cancer, with influenza vaccine administered in the oncological clinic, is more effective than an anonymous recall system, 205 children with oncohematological malignancies were randomised to one of three interventio...

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...

Background/objective: The management of chronic childhood idiopathic thrombocytopenic purpura (ITP) is distinct from acute ITP. Similar to the publication on acute ITP guidelines, the AIEOP (Associazione Italiana di Ematologia e Oncologia Pediatrica) considered it appropriate to develop consensus guidelines for chronic childhood ITP to provide use...

In order to evaluate the impact of influenza-like illness and the effectiveness of influenza vaccination in children with oncohematological disease who have completed cancer therapy, 182 children with a diagnosis of oncohematological disease were divided into two subgroups on the basis of the length of time off therapy (<6 months or 6-24 months) an...

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...

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...

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...

Autoimmune hemolytic anemia in children younger than 2 years of age is usually characterized by a severe course, with a mortality rate of approximately 10%. The prolonged immunosuppression following specific treatment may be associated with a high risk of developing severe infections. Recently, the use of monoclonal antibodies (rituximab) has allow...

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...

While Essential Thrombocytemia (ET) is a typical chronic myeloproliferative disease (MPD) in adults of median/advanced age, it is rarely seen in children. Literature is scarce on this issue and mostly focused on case reports. Current diagnostic criteria in adults are those of WHO2008; new biological markers show a growing clinical relevance. In con...

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...

We describe the survival patterns of 10,791 Italian children (age 0-14) diagnosed with cancer during 1989-1998 and who were included in the hospital-based registry of the Italian Association of Paediatric Haematology and Oncology. Five-year cumulative survival percentages were 76% for lymphoproliferative disorders and 68% for solid tumours. Surviva...

Consensus guidelines for diagnosis and treatment of acute childhood idiopathic thrombocytopenic purpura (ITP) were published in 2000 by the Italian Association of Pediatric Haematology and Oncology (AIEOP). The assessment of guideline implementation was the primary objective of the present study. Information on each newly diagnosed case of ITP refe...

The number of subjects that have successfully completed treatment for a cancer diagnosed during childhood and are entering adulthood is increasing over time. Members of the International Berlin-Frankfurt-Munster (I-BFM) Early and Late Toxicity Educational Committee (ELTEC) invited 45 paediatric cancer experts (representing oncologists, psychologist...

Quality of life (QoL) assessment in children with coagulation disorders is a relatively unstudied area. While hemophilia-specific questionnaires (such as Haemo-QoL) are available, no instrument for children with idiopathic thrombocytopenic purpura (ITP) has been validated yet. A disease-specific questionnaire for children with ITP was therefore dev...

Despite the increased survival of children with solid tumors, a significant proportion of cases still relapse following treatment discontinuation, and knowledge about the long-term outcome of this selected group of patients remains incomplete. To describe the long-term outcome of children treated for a solid tumor who relapsed after the elective en...

Il sistema PPOA, progettato dal CILEA e rivolto al monitoraggio di bambini guariti da tumore, viene presentato dai medici che ne hanno promosso la realizzazione. Si sottolinea il significato dell’iniziativa e l’interesse che suscita nell’ambiente medico scientifico. PPOA, a CILEA system aimed at the definition of homogeneous after the end of cancer...

Introduction: In the last two decades, treatment to prevent CNS relapses in childhood ALL has been characterized by a progressive replacement of cranial radiotherapy (CRT) with HD-MTX and/or protracted IT chemotherapy. AIEOP has already reported that HD-MTX (5 g/sqm x 4), associated with protracted use of IT MTX led to a 6-year isolated CNS relapse...

The rapid evolution of care and the constantly changing needs and expectations of patients and their families require flexibility and re-organisation of the caring and treatment activities. These include the increased need for high-specialised personal competence; communication and interpersonal skills; and a close collaboration and integration bet...