© Borgis - Postępy Nauk Medycznych 9/2013, s. 658-659
Jerzy R. Kowalczyk
This issue of the “Progress in Medicine” has been entirely devoted to pediatric oncology and hematology. It is also addressed to 50 anniversary of institutional pediatric oncology in Poland since initiated by Professor Józef Bożek in 1962 the specialized ward was established in the Institute of Mother and Child in Warsaw.
An editorial by Professor Michał Matysiak presents the history of pediatric hematology wards in Warsaw where children with leukemia and other disorders of hematopoietic system were treated. It was due to Professor Maria Ochocka and Professor Roma Rokicka-Milewska high activity and determination that successful therapy of childhood leukemia and diagnostics and treatment of bleeding disorders and different types of inborn anemias.
Acute lymphoblastic leukemia (ALL) diagnosed in the first year of life is a rare disease, but it causes several therapeutic problems, and, in contrary to ALL in children older than 1 year, the cure rate in neonates is still rather low. In the paper presented multicenter results of clinical, immunophenotypic and genetic characteristic of 36 infants with ALL treated in the hemato-oncologic centers in Poland. Infant ALL is characterized by more severe presentation as compared to ALL in older children. This is reflected by significantly higher initial leukocytosis, more frequent hepatosplenomegaly and central nervous system involvement. MLL gene aberrations are hallmark of infant ALL and are associated with pro-B-ALL immunophenotype. Infant ALL is characterized by significantly worse response to treatment as compared to ALL in older children.
Professor Jan Styczyński with his team has analysed 241 of hematopoietic stem cell transplantations in children performed in the Bydgoszcz center. Among auto-HSCT patients 28.5% has died and among allo-HSCT patients 41.2% has died due to disease relapse/progression or transplant-related complications. The authors concluded that disease relapse and infectious complications are the main cause of stem cell transplant failure.
The other article from the Bydgoszcz center presents the analysis of 79 consecutive patients undergoing allogeneic stem cell transplantation and treated with palifermin, a recombinant human keratinocyte growth factor used in adults to prevent oral mucositis following allogeneic stem cell transplantation. The authors were able to confirm that palifermin is a safe drug when used in children and adolescents undergoing allogeneic stem cell transplantation. The use of this drug leads to significant decrease of mucosal toxicity and frequency of acute and chronic GVHD.
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