RESUMEN
OBJECTIVE: The objective of this study was to assess the clinical impact and outcome of the SARS-CoV-2 infection on children with cancer or those who received a hematopoietic stem cell transplantation. METHODS: AIEOP (Italian Association of Pediatric Hematology and Oncology) performed a nationwide multicenter observational cohort study, including consecutive patients between April 2020 and November 2022. RESULTS: Twenty-five Italian centers participated and 455 patients were enrolled. We reported a significant increasing trend of symptomatic cases over the years, while the number of nonmild infections remained stable. Early infection after oncologic diagnosis (<60 days) and severe neutropenia were identified as independent risk factors for developing moderate, severe, or critical infections. The percentage of patients who were asymptomatic and mildly symptomatic and who stopped chemotherapy reduced over the years of the pandemic. Nine patients died, but no death was attributed to SARS-CoV-2 infection. CONCLUSIONS: SARS-CoV-2 infection presented a self-limiting benign course in the Italian pediatric oncohematology population during the pandemic, and its main consequence has been the discontinuation of cancer-directed therapies. The rate of patients who were asymptomatic and stopped chemotherapy reduced over the years, suggesting that the continuation of chemotherapy is a feasible option.
Asunto(s)
COVID-19 , Enfermedades Transmisibles , Trasplante de Células Madre Hematopoyéticas , Neoplasias , Niño , Humanos , SARS-CoV-2 , Neoplasias/complicaciones , Neoplasias/terapia , Neoplasias/epidemiología , Trasplante de Células Madre Hematopoyéticas/efectos adversosAsunto(s)
Antibacterianos , Farmacorresistencia Bacteriana Múltiple , Neoplasias Hematológicas , Niño , Humanos , Antibacterianos/efectos adversos , Ceftazidima/uso terapéutico , Ceftazidima/farmacología , Cefalosporinas/uso terapéutico , Combinación de Medicamentos , Bacterias Gramnegativas , Neoplasias Hematológicas/complicaciones , Neoplasias Hematológicas/tratamiento farmacológico , Pruebas de Sensibilidad Microbiana , Pseudomonas aeruginosa , Infecciones por Pseudomonas/tratamiento farmacológico , Estudios Retrospectivos , Tazobactam/uso terapéuticoRESUMEN
A case of a woman with congenital dyserythropoietic anemia type II (CDA-II), Gilbert's syndrome (GS) and trophic malleolar ulceration is described. The association of CDA-II and GS caused early gallstone formation that led the patient to undergo cholecystectomy at the age of 15. GS is typified by increased production of both unconjugated and monoconjugated bilirubin, which is more lithogenic. The development of ulcers is not typical of CDA-II, even though they are associated with many of the hemolytic anemias, and were thought in our patient to be due to a thrombophilic tendency which manifest with Antithrombin III and Protein C deficiency.