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Mizia-Malarz A.,Oddzial Onkologii | Musiol K.,Oddzial Onkologii | Matuszewski M.,Oddzial Onkologii | Sobol-Milejska G.,Oddzial Onkologii
Onkologia Polska | Year: 2013

Introduction: Secondary cancers are diagnosed in about 3-12% of children treated for malignancies after 20 years of observation. Their development is related to genetic predisposition and the applied anticancer therapy. Amongst cytostatic drugs carcinogenic properties are attributed to drugs from the group of epipodophyllotoxins and alkylating agents. The contribution of radiotherapy to the formation of secondary cancers has been raised. Aim of the study: The aim of the study was to assess the occurrence of secondary cancers in the material of the oncological department with an attempt to determine the risk factors of their development. Material and methods: Secondary cancers were diagnosed in 5 children (<1%) among 524 of children treated for malignant cancers in the years of 2000-2012 (including one child after treatment of the 1st cancer at another department). Results: In 3 cases secondary acute myeloblastic leukemia (sAML) type M4 and M5, MLL(+) were diagnosed, malignant brain tumour was diagnosed in 1 case and 1 child was diagnosed with thyroid adenoma. The time of development of the secondary cancer varied from 6 months after the beginning of the therapy of the first cancer (during the maintenance treatment) to 14 years after completion of the treatment. All patients were treated with epipodophyllotoxins (1.2-4.05 g/m2) and alkylating drugs (ifosfamide 9.0-78.0 g/m2, cyclophosphamide 10.5-27.2 g/m2). Radiotherapy was additionally applied to 4 patients. 4 patients died, including 3 in the progression of the secondary cancer without remission and 1 patient died as a result of the progression of the first cancer. Conclusions: 1. The risk of secondary cancers in children after cancer treatment is low and despite a very difficult prognosis, they aren't often the result of failure of cancer treatment in childhood. 2. Myeloblastic leukemias are the most common secondary cancers in children. 3. Due to the possible development of secondary cancers in patients who have undergone oncological treatment, in particular after therapy involving derivatives of podophyllotoxins, alkylating drugs and radiotherapy, those patients require long-term oncological control. Copyright © 2013 Cornetis.

Pienkowski T.,Klinika Nowotworow Piersi I Chirurgii Rekonstrukcyjnej | Pikiel J.,Poradnia Onkologiczna | Jagiello-Gruszfeld A.,Klinika Nowotworow Piersi I Chirurgii Rekonstrukcyjnej | Wojtukiewicz M.,University Medyczny | And 6 more authors.
Nowotwory | Year: 2011

Background. The Lapatinib Expanded Access Program (LEAP) was designed to provide access to lapatinib in combination with capecitabine for HER2-positive advanced breast cancer patients, who had progressed after trastuzumabcontaining therapy and had no other treatment option. Material and methods. HER2-positive locally advanced or metastatic breast cancer patients who had previously received anthracyclines, taxanes, and trastuzumab. Patients were assessed for progression-free survival (PFS) and overall survival (OS) and monitored for serious adverse events (SAE). Re s u l t s. As of 30 September 2008, 78 patients were enrolled in LEAP in Poland. The median treatment duration was 24.2 weeks. The median PFSs and OSs were not achieved. Estimated PFS after 24 weeks was 77%, and estimated OS after 30 weeks was 81%. Fourteen SAEs in 13 patients (16.7%) were reported, including decreased left ventricle ejection fraction (LVEF) in 3 patients (3.9%). Conclusions. These results demonstrate that even heavily pre-treated patients with HER2-positive locally advanced or metastatic breast cancer, who had progressed after trastuzumab-containing therapy may benefit from the treatment with lapatinib in combination with capecitabine.

Muszynska-Roslan K.,Klinika Onkologii i Hematologii Dzieciecej | Panasiuk A.,Klinika Onkologii i Hematologii Dzieciecej | Latoch E.,Klinika Onkologii i Hematologii Dzieciecej | Obitko-Pludowska A.,Klinika Onkologii i Hematologii Dzieciecej | And 5 more authors.
Onkologia Polska | Year: 2013

Introduction: Osteonecrosis is a documented complication of childhood cancer treatment. Aim of the study: Aim of the study was to evaluate clinical outcome of osteonecrosis in children and adolescents treated for malignancy in Polish Pediatric Leukemia, Lymphoma, Solid Tumors Study Group centers. Material and methods: Clinical course of avn was analyzed in 40 patients, diagnosed with childhood cancer between 2002 to 2011; 33 (82.5%) with ALL, 2 (5%) with NHL, 3 (7,5%) with solid tumors and 2 (5%) with severe aplastic anemia. Polymorphisms of potentially involved in avn genes (FokI i BsmI for witamin D receptor gene and XbaI i PvuII for estrogen α receptor gene) were determined using PCR-RFLP method. Results: Mean age of diagnosis of malignancy was 12.1±4.5 years (range 4.0-18.1), mean age of avn diagnosis was 14.6±4.3 years. Seventeen patients (42.5%) were diagnosed after completion of treatment. A majority of patients n=27 (67.5%) had multifocal involvement, 19 (47.5%) developed avn of hips. The main symptom was pain. In 22 patients diagnosis was established using MRI. The analyzed gene polymorphisms pattern was similar as in control group. The statistical analysis of genetic and clinical parameters was not performed because of small group of patients. Conclusions: Children and adolescents treated for malignancy, especially for ALL have a high risk of developing avn. Prospective study is required to evaluate skeletal morbidity in patients treated for childhood cancer in Polish Pediatric Leukemia, Lymphoma, Solid Tumors Study Group centers. Evidence-based guidelines for diagnosis and management of avn during and after childhood cancer should be considered. Copyright © 2013 Cornetis.

Opsoclonus-myoclonus syndrome (OMS) is defined as the acute onset of rapid, conjugate, non-phasic and multi-directional eye movements combined with myoclonic jerks of the head, trunk and limbs, ataxia and behavioral disturbances. Other names of this syndrome are a dancing eye syndrome (DES) and Kinsbourne syndrome. OMS can occur as an isolated neurological syndrome (50% of cases) or it can also coexist with or precede the diagnosis of neuroblastoma (2-3% of cases). The clinical course of OMS coexisting with NBL is characterized by the tendency to relapse. According to the literature, 60-80% of patients achieved a partial regression of the OMS symptoms, complete remission is possible only in 20% of cases. Oncological remission is achieved in the majority of children with NBL and coexisting OMS. The pathogenesis of OMS is still unclear. It is believed that the disease is determined immunologically, it is associated with neuroalergic reaction and induces autoimmune processes. The pathogenesis of OMS might be an autoimmune phenomenon mediated by antibodies cross-reacting with antigens on neuroblasts and neuronal cells in the cerebellum and the brain stem. Treatment includes surgery - total resection of the tumor, which in some cases results in complete regression of symptoms. In the absence of effects, steroids, immunotherapy or immunosuppressive therapy (cyclophosphamide, azathioprine) are applied. According to literature, a combination of cyclophosphamide (Cy) with dexamethasone (Dexa) gives satisfactory results. We report 3 girls (1.5-3 years) with NBL (retroperitoneal tumor) in whom symptoms of OMS were the first signs of cancer. None of the girls achieved remission of symptoms after surgery, without improvement after immunotherapy in combination with steroids. Marked improvement, almost complete remission of symptoms, was a result of immunosuppressive therapy (Cy with Dexa). Conclusions: 1. Opsoclonus-myoclonus syndrome rarely coexists with neuroblastoma in children and its treatment is usually difficult. 2. Immunosuppressive therapy according to literature and personal observations seems to be the most effective in the treatment of Kinsbourne syndrome coexisting with neuroblastoma. Copyright © 2010 Cornetis.

Sobol-Milejska G.,Oddzial Onkologii | Mizia-Malarz A.,Oddzial Onkologii | Musiol K.,Oddzial Onkologii | Koszutski T.,Klinika Chirurgii Dzieciecej SUM | Wos H.,Oddzial Onkologii
Acta Haematologica Polonica | Year: 2013

Pyomyositis is a term used to asses pyogenic infection of the skeletal muscle and develops as the result of bacteriemia and occurs most commonly in patients with various immunosuppressive diseases. Pyomyositis should be considered in the differential diagnosis in patients complaining of intensive muscle pain and fever. The usual causative organism is Staphylococcus aureus. We present a 3-year-old boy with acute lymphoblastic leukemia (ALL) and pyomyositis caused by Pseudomonas aeruginosa diagnosed in the course of induction therapy. The diagnosis of pyomyositis in the crural muscles of both legs was given based on imaging examinations: ultrasonography and magnetic resonance. © 2013 Polskie Towarzystwo Hematologów i Transfuzjologów, Instytut Hematologii i Transfuzjologii. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

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