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Aim: To study incidence, types and degrees of late effects in a geographical cohort of paediatric medulloblastoma and central nervous system primitive neuroectodermal tumour (CNS-PNET) survivors, and identify the need for rehabilitation., Methods: Between 1974 and 2013, 63 patients survived treatment for paediatric medulloblastoma and CNS-PNET at Oslo University Hospital, Norway. Of these, 50 accepted invitation and were included in this study., Results: Median follow-up was 20 years (range 3.2-41), and 96% of participants had developed late effects. Cognitive impairment was found in 72%, reduced hearing in 68%, endocrine deficits in 66%, epilepsy in 32% and another 30% had been diagnosed with one or more second primary neoplasms. Radiotherapy significantly increased risk of secondary primary neoplasms and endocrinological deficits, chemotherapy risk of ototoxicity and endocrinological deficits, and epilepsy was found significantly more often in CNS-PNET than medulloblastoma patients. Epilepsy was the main cause of cognitive impairments (full-scale IQ) in our study. 86% of participants had an unmet rehabilitation need., Conclusion: Significant late effects and unmet rehabilitation needs were documented in the large majority of survivors after treatment for paediatric medulloblastoma and CNS-PNET., (© 2020 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Parenteral iron abolishes the "early anaemia' in all mammals tested and increases packed cell volume (PCV) and haemoglobin concentration (Hb) significantly above adult levels. In the present study we examined the effect of parenteral iron upon serum immunoreactive erythropoietin (siEpo) concentration in young mice (age 6-24d) and in adult iron-deficient mice. Young BALB/CJ mice, from 5 to 23 d of age, and adult (60-100 d old)mice, some of which were iron deficient due to a low iron diet from the time of weaning, were given iron subcutaneously (iron sorbitol, Fe+3, 1.2 mg iron/100g body weight/injection). Iron was given as one single dose and the animals killed 20-24 h later. Control mice were similarly treated with saline. In young mice, from the age 10 d to weaning at 20 d, the siEpo level, measured 20-24 h after a single subcutaneous dose of iron, was 5 times greater than that in control mice (P < 0.0001). In contrast, there was no change in siEpo 20-24 h after a single subcutaneous dose of iron in adult mice, whether iron-deficient anaemic or normal. Thus, during the "early anaemia' in young mice over 10 d old, iron increased siEpo levels, whereas it had no such effect in iron-deficient and normal adult mice. This suggests that between ages 10 and 20 d, iron has additional effects in the regulation of erythropoiesis, which may not occur in adult or in 6-d-old mice.

We report the finding of inappropriately high estimates of erythropoietin (Epo) in 11% of serum samples tested by one commercial assay kit. These estimates were not confirmed when the same samples were tested independently in four other systems for the immunoassay of Epo. As yet no explanation has been found to account for the anomalously high estimates.