High-grade glioma in infants and very young children: characteristics, treatment, and outcomes.

PURPOSE: High-grade gliomas in infants and very young children (less than 3 to 5 years old) pose significant challenges due to the limited scientific literature available and high risks associated with treatments. This study aims to investigate their characteristics, treatment, and outcomes. METHODS: A cohort study was conducted at Children's Cancer Hospital, Egypt. Cases included children aged < 5 years old with confirmed CNS high-grade glioma. Baseline clinical and radiological characteristics, besides potential prognostic factors were assessed. RESULTS: In total, 76 cases were identified, 7 of them were < 1 year old. Gross- or near-total resection (GTR/NTR) was achieved in 32.9% of all cases. Of the tested cases, H3K27M-alteration was present in 5 subjects only. The 3-year OS and EFS for all cases were 26.9% and 15.4%, respectively. Extent of resection was the most important prognostic factor, as those achieving GTR/NTR experienced more than double the survival compared to those who do not (p = 0.05). Age had a "bimodal" effect on EFS, with those aged 1 to 3 years old faring better than younger and older age groups. Subjects with midline tumors had worse survival compared to non-midline tumors (1-year EFS = 18.5% vs 35%, respectively, p = 0.02). CONCLUSION: This study in a large cohort of HGG in infants and very young children offers insights into the characteristics and treatment challenges. Extent of resection, age group, and tumor localization are important prognostic factors. Further research with larger sample size is warranted to refine treatment approaches and improve outcomes.

Phylogenetic Analysis of Torque Teno Virus in Thalassemic Children in Egypt.

OBJECTIVE: Torque teno virus (TTV) is a ubiquitous virus that is commonly associated with blood transfusion. The main aims of this study were to evaluate the incidence of TTV in polytransfused children with thalassemia and to determine for the first time the prevalent TTV genotypes in Egypt. METHODS: TTV was detected in 2 groups by nested PCR: the first group comprised 200 children with thalassemia, and the second included age- and sex-matched healthy children with no history of blood transfusion. RESULTS: TTV was detected in 60 and 57%, respectively, of the children with thalassemia and the healthy children. Among the TTV-positive children with thalassemia, 71.6% were HCV positive. No hepatitis B surface antigen was detected in the thalassemic children. Significant elevations of alanine transaminase and aspartate transaminase were found in TTV-positive patients with thalassemia compared to TTV-negative patients. Phylogenetic analysis of sequenced TTV isolates showed close relationships to genotypes 1 and 2. CONCLUSION: TTV is highly prevalent among children with thalassemia in Egypt, with a relatively high infection rate also detected among healthy children.

Comparative study on the effect of low intensity laser and growth factors on stem cells used in experimentally-induced liver fibrosis in mice.

BACKGROUND AND STUDY AIMS: The therapeutic effects of human umbilical cord-derived mesenchymal stem cells (UC-MSCs) exposed to diode laser and/or hepatocyte growth factor (HGF) were compared in mice with experimental liver fibrosis induced by carbon tetra chloride (CCl4). MATERIAL AND METHODS: Animal model of liver cirrhosis was induced by intraperitoneal injection of CCl4 in a dose of 0.4ml/kg, twice a week for 6weeks. UC-MSCs were obtained from normal full term placentas and were exposed to diode laser and/or HGF. Before treatment, UC-MSCs were labelled with red fluorescent PKH26. Fifty four male mice weighing 25-35g were randomly divided into four groups control, stem cells, CCl4, and treated groups. After the experimental period, body and liver weights were recorded, and the liver specimens were processed for histological examination using haematoxylin and eosin, Periodic Acid-Schiff (PAS), and Masson's Trichrome staining (MT). RESULTS: Results showed that administration of UC-MSCs stimulated by diode laser and/or HGF improved body and liver weights, reduced vascular dilatation and congestion, reduced mononuclear cellular infiltration, reduced hepatocyte vacuolation, eosinophilia, and pyknosis. Furthermore, periportal fibrosis was minimized and PAS reaction was increased. These effects were maximum when UC-MSCs were exposed to both diode laser and HGF. CONCLUSION: UC-MSCs stimulated by both diode laser and HGF proved to be an effective therapeutic option in experimental liver fibrosis induced by CCl4 in mice.