Search

We analyzed the long-term outcome of 4865 patients treated in Studies 82, 87, 88, 91 and 95 for childhood acute lymphoblastic leukemia (ALL) of the Italian Association of Pediatric Hematology and Oncology (AIEOP). Treatment was characterized by progressive intensification of systemic therapy and reduction of cranial radiotherapy. A progressive improvement of results with reduction of isolated central nervous system relapse rate was obtained. Ten-year event-free survival increased from 53% in Study 82 to 72% in Study 95, whereas survival improved from 64 to 82%. Since 1991, all patients were treated according to Berlin-Frankfurt-Muenster (BFM) ALL treatment strategy. In Study 91, reduced treatment intensity (25%) yielded inferior results, but intensification of maintenance with high-dose (HD)-L-asparaginase (randomized) allowed to compensate for this disadvantage; in high-risk patients (HR, 15%), substitution of intensive polychemotherapy blocks for conventional BFM backbone failed to improve results. A marked improvement of results was obtained in HR patients when conventional BFM therapy was intensified with three polychemotherapy blocks and double delayed intensification (Study 95). The introduction of minimal residual disease monitoring and evaluation of common randomized questions by AIEOP and BFM groups in the protocol AIEOP-BFM-ALL 2000 are expected to further ameliorate treatment of children with ALL. [ABSTRACT FROM AUTHOR]

To evaluate the role of epiluminescence microscopy (ELM) in the differential diagnosis of cutaneous pigmented lesions, and to improve the early diagnosis of cutaneous malignant melanoma (CMM), 15,719 pigmented lesions from 8782 consecutive patients were evaluated using ELM with a hand-held video microscope imaging system (MS 500B Micro-Scopeman, Moritex). Comparison between risk levels as inferred from ELM screening and histology was performed on 2731 surgically excised lesions. ELM sensitivity, specificity, positive and negative predictive values, as well as agreement with histological results for the different subgroups of lesions, were determined. Overall agreement was 87·3% (ranging from 85·1% to 92·2% for melanocytic and non-melanocytic lesions, respectively); sensitivity and specificity were high (values ranging from 87·3% to 96·3% among different subsets of ELM-analysed lesions) and statistically significant (P < 0·0001). ELM screening identified 165 new cases of CMM with a high proportion of lesions (115; 70%) in an early phase of tumour growth (Breslow thickness ≤ 1·5 mm). Thus, ELM is helpful to the clinician in deciding which pigmented lesions need surgical excision, as well as in diagnosing early CMM lesions. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented that discusses detection of PICALM-MLLT10 in children with T-lineage acute lymphoblastic leukemia.

It has been reported that the mode of treatment does not strongly influence healing of histiocytosis X bone lesions. We have reviewed our experience with 16 patients showing isolated osseous involvement by histiocytosis X, with the aim of providing further data on the above observation. We have also looked for any correlation between rate of healing and skeletal localization of bone lesions or age of patients. A retrospective study confirms that patients with histiocytosis X who have isolated bone lesions follow a benign course. Based on data, it is suggested that isolated bone lesions be treated only if they are painful or pose a risk of pathologic fracture. We did not find a clear explanation of this phenomenon; perhaps it was due to a difference in the mechanism of ossification.

A letter to the editor is presented in response to the article "Palonosetron to Prevent Nausea and Vomiting in Children Undergoing BMT: Efficacy and Safety," by M. Ripaldi and colleagues published online in the February 22, 2010 issue.