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The use of biomarkers in detecting subclinical cardiotoxicity in doxorubicin-based treatment for paediatric patients with acute lymphoblastic leukaemia


The international standard protocol for acute lymphoblastic leukaemia (ALL), the most common haemato-oncological pathology at paediatric age, uses anthracyclines as antitumor agents, potentially associated with early or late onset cardiac damage. Currently, echocardiography is the gold standard in the diagnosis of cardiotoxicity, but several biomarkers are evaluated as a possible replacement, pending more extensive clinical studies. We started a prospective study in order to determine the role of two biomarkers, troponin and heart-type fatty acid binding protein, in the evaluation of cardiotoxicity in children over one year of age, diagnosed with ALL. Between February 2015 and April 2016, 20 patients were enrolled and monitored at diagnosis, during chemotherapy and four months after the end of reinduction, through cardiac evaluation and dosing of those two markers in five different points of the treatment protocol. During the first year of follow-up, the patients did not develop clinical signs of cardiac damage, but the study showed a slight increase in troponin levels during chemotherapy, with the return to baseline value after treatment cessation, and also a correlation with the total dose of anthracyclines given to the patient. On the other hand, the second biomarker, heart-type fatty acid binding protein, did not seem to be useful in detecting subclinical cardiac damage in these patients.

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The impact of immunological and biomolecular investigations on the outcome of children with acute lymphoblastic leukemia - experience of IIIrd Paediatric Clinic Timisoara

References 1. Inaba H, Greaves M, Mullighan CG. Acute lymphoblastic leukaemia. The Lancet. 2013 Jun;381(9881):1943-55. DOI: 10.1016/S0140-6736(12)62187-4 2. Bartram CR, Schrauder A, Köhler R, Schrappe M. Acute lymphoblastic leukemia in children: treatment planning via minimal residual disease assessment. Dtsch Arzteblatt Int. 2012 Oct;109(40):652-8. 3. Harrison CJ. Cytogenetics of paediatric and adolescent acute lymphoblastic leukaemia. Br J Haematol. 2009 Jan;144(2):147-56. DOI: 10.1111/j.1365-2141.2008.07417.x

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Mathematical model to predict methotrexate elimination in children with acute lymphoblastic leukemia

. Long-term results of NOPHO ALL-92 and ALL-2000 studies of childhood acute lymphoblastic leukemia. Leukemia. 2010;24(2):345-54. DOI: 10.1038/leu.2009.251 12. Mitchell C, Richards S, Harrison CJ, Eden T. Long-term follow-up of the United Kingdom medical research council protocols for childhood acute lymphoblastic leukaemia, 1980-2001. Leukemia. 2010;24(2):406-18. DOI: 10.1038/leu.2009.256 13. Evans WE, Relling MV, Rodman JH, Crom WR, Boyett JM, Pui CH. Conventional compared with individualized chemotherapy for childhood acute

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Perforacja jelit jako powikłanie chemioterapii ostrej białaczki limfoblastycznej u dzieci – opis dwóch przypadków

acute lymphoblastic leukemia. Med Sci Monit 2015;21:1656–61. 10.12659/MSM.893142 Yang L Yu L Chen X Hu Y Wang B Clinical analysis of adverse drug reactions between vincristine and triazoles in children with acute lymphoblastic leukemia Med Sci Monit 2015 21 1656 – 61 [11] Ceppi F, Langlois-Pelletier C, Gagné V, et al. Polymorphisms of the vincristine pathway and response to treatment in children with childhood acute lymphoblastic leukemia. Pharmacogenomics 2014;15(8):1105–16. 10.2217/pgs.14.68 Ceppi F Langlois-Pelletier C Gagné V et al

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Infant acute leukemia with lineage switch at relapse expressing a novel t(4;11)(q21;q23) MLL-AF4 fusion transcript

References 1. De Braekeleer E, Douet-Guilbert N, Le Bris MJ, Basinko A, Morel F, De Braekeleer M. Gene expression profiling of adult t(4;11)(q21;q23)-associated acute lymphoblastic leukemia reveals a different signature from pediatric cases. Anticancer Res. 2012 Sep;32(9):3893-9 2. De Braekeleer M, Morel F, Le Bris MJ, Herry A, Douet-Guilbert N. The MLL gene and translocations involving chromosomal band 11q23 in acute leukemia. Anticancer Res. 2005 May-Jun;25(3B):1931-44 3. Drexler HG, Quentmeier H

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The prognostic value of mean platelet volume in cancer patients

the patients without VTE (median 7.2 fL, p = 0.034). Patients with baseline MPV 6.8 fL or below more often developed VTE compared to patients with higher MPV values (19% vs. 5.5%, p = 0.0244). Of the HL patients, in both the univariate and multivariate models, the patients with baseline low MPV levels had an above twofold increased risk of VTE development [ 29 ]. There are also reports about the prognostic role of platelet parameters in acute lymphoblastic leukemia (ALL) in pediatric patients [ 30 , 31 ]. ALL is the most common type of cancer

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Genetic testing in pediatrics - a narrative essay of challenges and possibilities in Romania

outcome of children with acute lymphoblastic leukemia - experience of IIIrd Paediatric Clinic Timisoara. Rev Romana Med Lab. 2018;26(1):77-85. DOI: 10.1515/rrlm-2017-0029 16. Tripon F, Crauciuc GA, Moldovan VG, Bogliș A, Benedek IJ, Lázár E, et al. Simultaneous FLT3, NPM1 and DNMT3A mutations in adult patients with acute myeloid leukemia - case study. Rev Romana Med Lab. 2019;27(3):245-54. DOI: 10.2478/rrlm-2019-0022 17. Oltean A, Chincesan MI, Marginean O, Horvath E. Myelodysplastic syndrome with myelofibrosis in a 12-year-old patient - A case report. Rev

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Infectious complications in children and adults with hematological malignancies

]. Fig. 1 Overall cumulative incidence of infections in pediatric hematology and oncology (PHO) and pediatric hematopoietic stem cell transplantation (HCT) settings between 2012 and 2017: (A and B) including possible, probable, and proven IFD; (C and D) including probable and proven but not possible IFD Infections in pediatric hematology and oncology setting Acute lymphoblastic leukemia (ALL) The analysis included 1363 patients, with newly diagnosed ALL (2012–2017). The patients received therapy according to the ALL IC-BFM 2002 and 2009 (Intercontinental

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Myelodysplastic syndrome with myelofibrosis in a 12-year-old patient – A case report

lymphoblastic leukaemia: implications for disease biology. Leuk Res. 2006;30:233-239. DOI: 10.1016/j.leukres.2005.06.011 4. Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009;1145(5):937-51. DOI: 10.1182/blood-2009-03-209262 5. Tefferi A. Pathogenesis of myelofibrosis with myeloid metaplasia. J Clin Oncol. 2005;23(33):8520-30. DOI: 10.1200/JCO.2004

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A new assay to identify recurrent mutations in acute myeloid leukemia using next-generation sequencing

, Ferrero S, Pepin F, Drandi D, Monitillo L, et al. Next-Generation Sequencing and Real-Time Quantitative PCR for Minimal Residual Disease (MRD) Detection Using the Immunoglobulin Heavy Chain Variable Region: A Methodical Comparison in Acute Lymphoblastic Leukemia (ALL), Mantle Cell Lymphoma (MCL) and Multiple Myeloma (MM). ASH 2012, abstract 788. 13. Schmitt MW, Kennedy S R, Salk JJ, Fox E J, Hiatt JB, Loeb LA. Detection of ultra-rare mutations by next-generation sequencing. Proc Natl Acad Sci USA. 2012 Sep 4;109(36):14508-13. DOI: 10.1073/pnas.1208715109

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