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  • 1. Björklund, Elisabet
    et al.
    Matinlauri, Irma
    Tierens, Anne
    Axelsson, Susanne
    Forestier, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Pediatrik.
    Jacobsson, Stefan
    Ahlberg, Asa Jeppsson
    Kauric, Goran
    Mäntymaa, Pentti
    Osnes, Liv
    Penttilä, Tarja-Leena
    Marquart, Hanne
    Savolainen, Eeva-Riitta
    Siitonen, Sanna
    Torikka, Kerstin
    Mazur, Joanna
    Porwit, Anna
    Quality control of flow cytometry data analysis for evaluation of minimal residual disease in bone marrow from acute leukemia patients during treatment.2009Inngår i: Journal of pediatric hematology/oncology (Print), ISSN 1077-4114, E-ISSN 1536-3678, Vol. 31, nr 6, s. 406-415Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Low levels of leukemia cells in the bone marrow, minimal residual disease (MRD), are considered to be a powerful indicator of treatment response in acute lymphatic leukemia (ALL). A Nordic quality assurance program, aimed on standardization of the flow cytometry MRD analysis, has been established before implementation of MRD at cutoff level 10 as one of stratifying parameters in next Nordic Society of Pediatric Hematology and Oncology (NOPHO) treatment program for ALL. In 4 quality control (QC) rounds 15 laboratories determined the MRD levels in 48 follow-up samples from 12 ALL patients treated according to NOPHO 2000. Analysis procedures were standardized. For each QC round a compact disc containing data in list-mode files was sent out and results were submitted to a central laboratory. At cutoff level 10, which will be applied for clinical decisions, laboratories obtained a high concordance (91.6%). If cutoff level 10 was applied, the concordance would be lower (85.3%). The continuing standardization resulted in better concordance in QC3 and QC4 compared with QC1 and QC2. The concordance was higher in precursor B as compared with T-cell ALL. We conclude that after standardization, flow cytometry MRD detection can be reliably applied in international, multicenter treatment protocols.

  • 2. Diffner, Eva
    et al.
    Gauffin, Fredrika
    Anagnostaki, Lola
    Nordgren, Ann
    Gustafsson, Bertil
    Sander, Birgitta
    Gustafsson, Britt
    Persson, Jenny Liao
    Laboratory Medicine, Clinical Research Center, Lund University.
    Expression of VEGF and VEGF Receptors in Childhood Precursor B-cell Acute Lymphoblastic Leukemia Evaluated by Immunohistochemistry2009Inngår i: Journal of pediatric hematology/oncology (Print), ISSN 1077-4114, E-ISSN 1536-3678, Vol. 31, nr 9, s. 696-701Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Perturbation in the expression and signaling pathways of vascular endothelial growth factor (VEGF) has been linked to pathogenesis of hematologic malignancies. We investigated the expression and clinical importance of VEGF and two of its receptors, VEGFR-1 and VEGFR-2, in childhood precursor B-cell acute lymphoblastic leukemia (pre-B ALL) by using immunohistochemistry. These angiogenic proteins were expressed in the majority of leukemic bone marrow samples. Notably, pre-B ALL patients had significantly increased expression of VEGFR-1 compared with no expression in the nonmalignant group, indicating a link between VEGFR-1 protein expression and pre-B ALL. These novel findings suggest that VEGFR-1 may have clinical importance in childhood pre-B ALL.

  • 3.
    Forestier, Erik
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Pediatrik.
    Schmiegelow, Kjeld
    The incidence peaks of the childhood acute leukemias reflect specific cytogenetic aberrations.2006Inngår i: Journal of pediatric hematology/oncology (Print), ISSN 1077-4114, E-ISSN 1536-3678, Vol. 28, nr 8, s. 486-95Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The correlation between age and karyotype was studied in 1425, 0 to 14.9 years old children who were diagnosed with acute lymphoblastic leukemia (ALL) or acute myeloblastic leukemia. Almost 80% of the non-Down B-cell precursor ALL cases in the 2 to 7 years frequency peak group who had aberrant cytogenetic results had either a high-hyperdiploid clone (51 to 61 chromosomes) or a translocation t(12;21)(p13;q22). Among B-cell precursor ALL cases, high white blood cell counts correlated with earlier age at diagnosis (rS=-0.23; P<0.001) being most evident for 11q23/MLL-aberrations, translocation t(12;21)(p13;q22), and high-hyperdiploidy. Among acute myeloblastic leukemia patients, frequency peaks were found for those with MLL/11q23 rearrangements (peak: first year), Down syndrome (peak: second to third year), or cytogenetic abnormalities other than translocations t(8;21), t(15;17), and inv(16)/t(16;16) (peak: first to third year). The epidemiology of the cytogenetic subsets of acute leukemias questions whether age as a disease-related prognostic parameter has any relevance in childhood leukemia clinical research beyond being a surrogate marker for more important, truly biologic features such as cytogenetic aberrations and white cell count at diagnosis. Further research is needed to explore whether the 2 to 7 years age incidence peak in childhood ALL harbor yet unidentified cytogenetic subsets with the same natural history as the high-hyperdiploid and t(12;21)-positive leukemias.

  • 4. Gustafsson, Britt
    et al.
    Honkaniemi, Emma
    Goh, Shan
    Giraud, Geraldine
    Forestier, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Pediatrik.
    von Dobeln, Ulrika
    Allander, Tobias
    Dalianis, Tina
    Bogdanovic, Gordana
    KI, WU, and Merkel Cell Polyomavirus DNA was not Detected in Guthrie Cards of Children who Later Developed Acute Lymphoblastic Leukemia2012Inngår i: Journal of pediatric hematology/oncology (Print), ISSN 1077-4114, E-ISSN 1536-3678, Vol. 34, nr 5, s. 364-367Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Neonatal dried blood spots (Guthrie cards) have been used to demonstrate a prenatal origin of clonal leukemia-specific genetic aberrations in several subgroups of childhood acute lymphoblastic leukemia (ALL). One hypothesis suggests that an infectious agent could initiate genetic transformation already in utero. In search for a possible viral agent, Guthrie cards were analyzed for the presence of 3 newly discovered polyomavirus Karolinska Institutet polymavirus (KIPyV), Washington University polyomavirus (WUPyV), and Merkel cell polyomavirus (MCPyV). Methods: Guthrie cards from 50 children who later developed ALL and 100 matched controls were collected and analyzed by standard or real-time polymerase chain reaction for the presence of the VP1 region of KIPyV, WUPyV, and MCPyV, and the LT region for MCPyV. Results and Conclusions: DNA from KIPyV, WUPyV, and MCPyV was not detected in neonatal blood samples from children with ALL or controls. Prenatal infections with these viruses are not likely to be etiological drivers for childhood leukemogenesis.

  • 5.
    Jarvis, Kirsten B.
    et al.
    Department of Pediatric Hematology and Oncology, Oslo University Hospital, Rikshospitalet, Postboks 4950, Nydalen, Oslo, Norway; Pediatric Research, Oslo University Hospital, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
    Andersson, Nadine G.
    Department for Pediatric Hematology and Oncology, Skåne University Hospital, Lund, Sweden.
    Giertz, Mia
    Department of Pediatric Hematology and Oncology, Uppsala University Hospital, Sweden; Department of Women's and Children's Health, University of Uppsala, Uppsala, Sweden.
    Järvelä, Liisa
    Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Finland; Department of Clinical Sciences, University of Turku, Turku, Finland.
    Lindinger, Olle
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Pediatrik.
    Långström, Satu
    Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
    Niinimäki, Riitta
    PEDEGO Research Unit, University of Oulu, Finland; Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
    Palmu, Sauli
    Faculty of Medicine and Health Technology, Tampere University, Finland; Center for Child Health Research, Tampere University, Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
    Trakymiene, Sonata S.
    Center for Pediatric Oncology and Hematology, Children's Hospital, Vilnius University Hospital Santaros Klinikos, Lithuania; Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
    Tuckuviene, Ruta
    Department of Pediatrics, Aalborg University Hospital, Aalborg, Denmark.
    Vepsäläinen, Kaisa
    Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.
    Ranta, Susanna
    Astrid Lindgren Children's Hospital, Karolinska University Hospital, Sweden; Department of Women's and Children's Health, Karolinska Insitutet, Stockholm, Sweden.
    Frisk, Tony
    Astrid Lindgren Children's Hospital, Karolinska University Hospital, Sweden; Department of Women's and Children's Health, Karolinska Insitutet, Stockholm, Sweden.
    Asymptomatic Right Atrial Thrombosis after Acute Lymphoblastic Leukemia Treatment2021Inngår i: Journal of pediatric hematology/oncology (Print), ISSN 1077-4114, E-ISSN 1536-3678, Vol. 43, nr 4, s. E564-E566Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Right atrial thrombosis is a rare, but potentially serious complication of acute lymphoblastic leukemia treatment. We conducted a retrospective multicenter study to assess the incidence, treatment, and outcome of asymptomatic right atrial thrombosis detected at routine echocardiography of children after acute lymphoblastic leukemia treatment in the Nordic and Baltic countries. Eleven (2.7%, 95% confidence interval, 1.4-4.9) of 406 patients had asymptomatic right atrial thrombosis, ranging from 10 to 25 mm at detection. Three patients were treated with anticoagulation. None of the thromboses affected cardiac function, and they showed neither sign of progress nor spontaneous or treatment-related regress at follow-up.

  • 6.
    Pramanik-Jonsson, Lotta
    et al.
    Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet; Section of Pediatric Hematology, Immunology and HCT, Astrid Lindgren Children's Hospital.
    Borssen, Magnus
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap. Section of Pediatric Hematology and Oncology, Child and Adolescent Medical Center, University Hospital of Umeå, Umeå, Sweden.
    Vonlanthen, Sofie
    Department of Clinical Immunology and Transfusion Medicine, Medical Diagnostics Center, Karolinska University Hospital, Stockholm, Sweden.
    Nilsson, Frans
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap. Section of Pediatric Hematology and Oncology, Child and Adolescent Medical Center, University Hospital of Umeå, Umeå, Sweden.
    Sundin, Mikael
    Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet; Section of Pediatric Hematology, Immunology and HCT, Astrid Lindgren Children's Hospital.
    Severe thrombocytopenia due to bone marrow failure in children with dyskeratosis congenita does not respond to eltrombopag treatment: case series2024Inngår i: Journal of Pediatric Hematology/Oncology, ISSN 1077-4114, E-ISSN 1536-3678, Vol. 46, nr 1, s. 57-62Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Dyskeratosis congenita is a rare inherited disease with classic cutaneous symptoms, sometimes accompanied with more severe extracutaneous manifestations such as bone marrow failure, which can be lethal. Eltrombopag is an orally available thrombopoietin receptor agonist in clinical use for increasing platelet levels in patients with immune thrombocytopenia and aplastic anemia. Here, 3 pediatric patients with dyskeratosis congenita are presented with varying disease severity, in which off-label eltrombopag treatment had no clinical effect on bone marrow failure. This, in addition to the negative results in a previous case report, supports the preclusion of eltrombopag use in dyskeratosis congenita.

  • 7. Ranta, Susanna
    et al.
    Kalzén, Håkan
    Nilsson, Anna
    von Schewelov, Katarina
    Broman, Lars M.
    Berner, Jonas
    Fläring, Urban
    Norén-Nyström, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Pediatrik.
    Svahn, Johan E.
    Palle, Josefine
    Törnudd, Lisa
    Karlsson, Lene
    Mellgren, Karin
    Abrahamsson, Jonas
    Harila-Saari, Arja
    Extracorporeal Membrane Oxygenation Support in Children With Hematologic Malignancies in Sweden2021Inngår i: Journal of Pediatric Hematology/Oncology, ISSN 1077-4114, E-ISSN 1536-3678, Vol. 43, nr 2, s. e272-e275Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Extracorporeal membrane oxygenation (ECMO) is used in severe respiratory and/or circulatory failure when conventional critical care fails. Studies on patients with hematologic malignancies on ECMO have shown contradictory results; immunosuppression and coagulopathy are relative contraindications to ECMO.

    Observations: This nationwide Swedish retrospective chart review identified 958 children with hematologic malignancies of whom 12 (1.3%) required ECMO support. Eight patients survived ECMO, 7 the total intensive care period, and 6 survived the underlying malignancy.

    Conclusions: ECMO may be considered in children with hematologic malignancy. Short-term and long-term survival, in this limited group, was similar to that of children on ECMO at large.

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