Search

The treatment of endocarditis in patients with haemophilia remains challenging and proper management should include a multidisciplinary team approach, appropriate hemostatic therapy, and careful postoperative monitoring. Catheter-related infections, children, endocarditis, factor VIII, haemophilia A, Staphylococcus aureus, central venous catheters Keywords: catheter-related infections; central venous catheters; children; endocarditis; factor VIII; haemophilia A; Staphylococcus aureus EN catheter-related infections central venous catheters children endocarditis factor VIII haemophilia A Staphylococcus aureus 367 369 3 01/27/23 20230101 NES 230101 INTRODUCTION Prophylaxis with factor VIII replacement is considered the standard of care for children with haemophilia A.[1] Venous access is critical for regular prophylaxis; therefore, in some pediatric patients, it is required to implant a central venous catheter (CVC).[2] The most common complications associated with the central venous catheter are infections, venous thrombosis and mechanical complications.[[3]] Endocarditis secondary to CVC in immunocompetent children with haemophilia is an infrequent but severe complication with an unpredictable course.[[5], [7]] We report a case of successfully treated catheter-related tricuspid valve infective endocarditis (TVIE) in a child with severe haemophilia A complicated by an anti-FVIII inhibitor. The authors also emphasize that a catheter-related bloodstream infection should be suspected in a child with a fever of unknown origin, haemophilia and implanted CVC. [Extracted from the article]

Objectives: The aim of this population‐based, retrospective study was to analyze biological and clinical features and treatment results in children diagnosed with MPAL in all Polish pediatric oncology centers between 2007 and 2018. Methods: Among 2893 children and adolescents diagnosed and treated for acute leukemia, 39 (1.35%) patients fulfilled the WHO criteria of MPAL. The T/myeloid phenotype was most prevalent. Results: Cytogenetics findings were seen in 2 (5.1%), while chromosomal abnormalities were found in 14 (35.9%) patients. Thirty‐two patients achieved CR‐1, including 23 (92.0%) treated with ALL‐directed chemotherapy and 9 (64.3%) treated with AML‐type induction regimens. Within these patients, 4 (12.5%) died due to treatment‐related complications and 11 (34.4%) relapsed. Nineteen (63.3%) patients underwent allo‐HSCT in CR‐1 and 14 (73.7%) of them have been in CR‐1. In total, 17 (43.6%) patients remain in CR‐1 for 1‐12 years, including 14 (58.3%) with T/myeloid MPAL. The 5‐year pOS and pEFS were 51.8% and 44.2%, respectively. The overall survival for ALL‐directed therapy was significantly better than the one for AML‐type chemotherapy (P =.001). It was also better for patients who underwent HSCT in CR‐1 (P =.001). Conclusions: The prognosis of MPAL is unsatisfactory, but initial treatment with ALL‐directed chemotherapy consolidated with allo‐HSCT improves the outcomes in MPAL. [ABSTRACT FROM AUTHOR]

Anti-cancer treatment in children can deteriorate gonadal function and affect future fertility. We analyzed the hormonal markers of gonadal function in adolescent leukemia survivors, treated in childhood with different levels of aggressiveness. We analyzed hormone levels in 69 adolescents and young adults, leukemia survivors stratified into standard (SR), intermediate (IR), and high (HR) risk groups, and in 80 healthy controls (38 men) at a similar age. We assessed follicular stimulating hormone (FSH), luteinizing hormone (LH), and inhibin B in the whole group, testosterone in males, and E2 and anti-Müllerian hormone (AMH) in females. Males classified into HR group presented, in comparison to control, higher levels of FSH, LH, lower inhibin B, and normal testosterone, whereas in SR and IR group, the hormonal values were comparable to the control. In females, in all risk groups, the levels of FSH, LH, E2, and inhibin B were comparable with the control, but the mean AMH levels were slightly lowered. We did not observe the effect of prophylactic cranial irradiation (12 or 18 Gy) or the time of treatment (before vs. during puberty) on hormone levels. In females, a positive correlation was found between the time interval after the end of treatment and AMH levels. Male leukemia survivors having undergone more intensive chemotherapy show the symptoms of disturbed spermatogenesis and need to be followed-up in the future. Women, irrespective of the risk group, can develop the signs of preterm ovarian insufficiency. They should be informed about the impact of the treatment on gonadal function., (©2019 John Wiley & Sons, Ltd.)