Anti-PD-1 Therapy in Advanced Pediatric Malignancies in Nationwide Study: Good Outcome in Skin Melanoma and Hodgkin Lymphoma.

BACKGROUND/AIM: The role of immune checkpoint inhibitors (ICIs; anti-PD1) in the treatment of childhood cancers is still evolving. The aim of this nationwide retrospective study was to assess the safety and effectiveness of ICIs used in a group of 42 patients, with a median age of 13.6 years, with various types of advanced malignancies treated in pediatric oncology centers in Poland between 2015 and 2023. RESULTS: The indications for treatment with anti-PD1 were as follows: Hodgkin lymphoma (11); malignant skin melanoma (9); neuroblastoma (8); and other malignancies (14). At the end of follow-up, complete remission (CR) was observed in 37.7% (15/42) of children and disease stabilization in 9.5% (4/42), with a mean survival 3.6 (95% CI = 2.6-4.6) years. The best survival (OS = 1.0) was observed in the group of patients with Hodgkin lymphoma. For malignant melanoma of the skin, neuroblastoma, and other rare malignancies, the estimated 3-year OS values were, respectively, 0.78, 0.33, and 0.25 (p = 0.002). The best progression-free survival value (0.78) was observed in the group with malignant melanoma. Significantly better effects of immunotherapy were confirmed in patients ≥ 14 years of age and good overall performance ECOG status. Severe adverse events were observed in 30.9% (13/42) patients.

Systemic inflammatory markers and serum lactate dehydrogenase predict survival in patients with Wilms tumour.

Introduction: Markers of inflammation such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have been found to be associated with survival in cancer patients. The aim of the current study was to establish the prognostic significance of simple laboratory markers of systemic inflammation in paediatric patients diagnosed with Wilms tumour (WT). Additionally, we aimed to compare the complete blood count (CBC) parameters of WT patients and the non-oncological control group. Material and methods: The study group included 88 children diagnosed with WT. Clinicopathological data, as well as CBC, C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels at diagnosis, were obtained. Additionally, the laboratory results of 62 healthy control paediatric patients were collected. Uni- and multivariate proportional Cox's hazard analyses were computed to create a model predicting relapse-free survival (RFS) and overall survival (OS) in the study group. Results: High CRP, LDH, and NLR were associated with a higher stage of WT and shorter RFS, whereas all parameters correlated with OS. In multivariate analysis, only LDH levels had adverse significance in predicting RFS. C-reactive protein and LMR retained their prognostic value in the multivariate model predicting OS. Comparing the WT group with controls, high LDH, high CRP, high NLR, and high PLR were associated with WT presence. Conclusions: Preoperative LDH, CRP, NLR, PLR, and LMR have significant prognostic value in patients with WT independently of age and stage. Combined low CRP and high LMR identified the group of patients with excellent OS. Patients with high LDH were characterized by the highest risk of relapse.

Atypical imaging features of adrenal gland lesions in children - report of three cases and review of literature.

BACKGROUND: The differential diagnosis of adrenal pathology depends on the child's age and imaging findings. CASE REPORT: Three children without clinical symptoms of neoplasm, with an adrenal lesion discovered on diagnostic ultrasound imaging. Laboratory tests for neoplasm were negative. The final diagnosis was based on histopathological examinations after surgical resection. CONCLUSIONS: 1. The value of diagnostic imaging and laboratory tests in differential diagnosis of adrenal gland lesions is limited. 2. Malignant tumors of adrenal glands should be taken into account in children. 3. Surgical resection should be considered in diagnostic algorithm of adrenal gland masses. 4. The final diagnosis is always based on histopathological examination.

[Erythropoietin treatment of infants with anaemia in the first three months of life]. / Leczenie erytropoetyna niemowlat z niedokrwistoscia pierwszego kwartalu zycia.

UNLABELLED: Synthesis of recombinant human erythropoietin opened new possibilities for treatment of anaemia in infants. AIM: To assess the safety and effects of this treatment of anaemia in infants. MATERIAL AND METHODS: The study included 111 infants with anaemia aged between 3 and 10 weeks. Children were referred to the One Day Clinic of the Department of Paediatrics, Haematology and Oncology, Warsaw Medical University, by family doctors because of low haemoglobin concentration, in spite of iron supplementation. Patients were divided into two groups: group A - term infants and B - preterm infants. Both these groups were divided according to risk factors: serological incompatibility and infection at birth or just after birth. Recombinant human erythropoietin was given subcutaneously in doses of 500 IU/kg b. w./week. Therapy was ended when haemoglobin concentration reached 11 g/dl. RESULTS: Initial haemoglobin concentration in serum is the main factor which influence the length of recombinant human erythropoietin therapy of anaemia both in preterm and term infants. Serological incompatibility and infection at birth and just after birth lengthen the period of erythropoietin treatment of anaemia in both groups of patients. CONCLUSIONS: Recombinant human erythropoietin is an effective and fully safe drug in the treatment of anaemia in the first three months of life, both in preterm and term infants. Its high effectiveness is confirmed by comparative analysis of haematologic parameters in the first trimester of retrospective control group of infants without recombinant human erythropoietin therapy and term infants who had been treated with erythropoietin.