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A letter to the editor about the amplification in human mantle cell lymphoma is presented.

Background: Fulminant myocarditis (FM) is a potentially lethal disease with a wide spectrum of clinical presentation, thus making the diagnosis hard to depict. In cases where acute circulatory failure occurs venoarterial (VA) extracorporeal membrane oxygenation (ECMO) support is a valid management strategy, especially in the pediatric and adult patients. This study aims to report the results of VA ECMO for FM in our Institution., Methods: Between April 2009 and January 2021, 17 consecutive patients presenting with FM were supported using VA ECMO. We collected data dividing the population between infants, children and young adults. There were 8 male and 9 female patients, median age of 5.2 years [interquartile range (IQR), 2 months to 32 years] and median body weight of 16 kg (IQR, 3.8-56 kg). FM etiology was viral in 8 patients (47%), bacterial in 1 (6%), 2 giant cellular myocarditis (12%) and in 6 patients (35%) the etiology was unknown. Where it was possible also a cardiac biopsy was performed, usually during ECMO or vent implant. The endpoints of the study are: survival, incidence of ECMO-related complications, weaning rate from ECMO, recovery of cardiac function and the association between rescue ECMO (r-ECMO) and no-weaning/mortality. For the survival analysis we divided the population into three groups: infants (0-2 months; n=5), children (2-6 years; n=5) and young adults (24-40 years; n=7)., Results: After a median duration of 168 hours (IQR, 120-240 hours), 13 patients were weaned from support (weaning rate 76 %), 2 (12%) underwent respectively cardiac transplantation and Bi-Vad Berlin Heart implantation and 2 (12%) died while on ECMO support. Bleeding occurred in 6 (35%) patients, infection in 8 (47%) and 5 (29%), all of them infants, required peritoneal dialysis for acute kidney injury. Overall mortality was 35% (6/17 patients): two patients died during ECMO support due to persistent cardiac failure, arrhythmias and bleeding; three patients died after ECMO weaning (2 due to recurrent ventricular failure and 1 for respiratory complications) and 1 died due to multi-organ failure (MOF) after Bi-VAD implantation. Overall survival at follow-up was 65%, with a statistically significant difference (P=0.05) between age groups: in the infant group was 20% (1/5), in the children group 60% (3/5) and in the adult group 100% (7/7). There was no association between r-ECMO and weaning failure (P=0.55) or hospital mortality (P>0.99). During a median follow-up of 76 months (IQR, 52-99 months), there were no late deaths, 1 patient presented a minor neurological sequela, while cardiac function had fully recovered in all late survivors., Conclusions: The present experience shows that VA ECMO is an effective bridge to myocardial function recovery in patients with FM, including those with circulatory collapse. The rate of hospital complications is decent when in light of the otherwise fatal course of the disease., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-24-29/coif). The column “Pediatric Heart” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

Background: Isolated coronary arteriovenous fistulas are extremely rare, accounting for 0.08-0.4% of all congenital heart disease. Closure of the fistula is recommended in cases of large dimensions, relevant left-right shunt, or ischaemic events. Thrombosis of the coronary aneurysms may occur as a postoperative complication., Case Summary: We report a case of a coronary fistula between the circumflex artery and coronary sinus with giant aneurysm. After a failed percutaneous closure attempt, the patient was surgically treated without major postoperative complications. Despite therapeutic anticoagulation and antiplatelet therapy, she presented at clinical follow-up with thrombosis of the dilated coronary artery without signs or symptoms of ischaemia., Discussion: Management of coronary artery fistula may be challenging in cases in which initial percutaneous closure is unsuccessful. This particular case also highlights the importance of close follow-up, despite optimal therapy, to detect potentially lethal complications related to the low flow in the dilated coronary aneurysm., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.)

To investigate the patterns of genetic lesions in a panel of 23 human multiple myeloma cell lines (HMCLs), we made a genomic integrative analysis involving FISH, and both gene expression and genome-wide profiling approaches. The expression profiles of the genes targeted by the main IGH translocations showed that the WHSC1/MMSET gene involved in t(4;14)(p16;q32) was expressed at different levels in all of the HMCLs, and that the expression of the MAF gene was not restricted to the HMCLs carrying t(14;16)(q32;q23). Supervised analyses identified a limited number of genes specifically associated with t(4;14) and involved in different biological processes. The signature related to MAF/MAFB expression included the known MAF target genes CCND2 and ITGB7, as well as genes controlling cell shape and cell adhesion. Genome-wide DNA profiling allowed the identification of a gain on chromosome arm 1q in 88% of the analyzed cell lines, together with recurrent gains on 8q, 18q, 7q, and 20q; the most frequent deletions affected 1p, 13q, 17p, and 14q; and almost all of the cell lines presented LOH on chromosome 13. Two hundred and twenty-two genes were found to be simultaneously overexpressed and amplified in our panel, including the BCL2 locus at 18q21.33. Our data further support the evidence of the genomic complexity of multiple myeloma and reinforce the role of an integrated genomic approach in improving our understanding of the molecular pathogenesis of the disease. This article contains Supplementary Material available at http://www.interscience.wiley.com/jpages/1045-2257/suppmat., (Copyright (c) 2006 Wiley-Liss, Inc.)