IntroductionChildhood B‐cell precursor acute lymphoblastic leukemia (BCP‐ALL) can be traced back ... more IntroductionChildhood B‐cell precursor acute lymphoblastic leukemia (BCP‐ALL) can be traced back to birth using leukemic clone‐specific immunoglobulin heavy chain (IGH) rearrangements, implying prenatal origin of this disease.MethodsWe retrospectively analyzed neonatal blood spots (Guthrie cards) of 24 patients with childhood BCP‐ALL aged 1–9.6 years (median 3.1 years) for the presence of clonotypic IGH rearrangements identified in diagnostic bone marrow samples. Based on the sequences of IGH rearrangements, 2 patient‐specific primers were designed for each patient and used in semi‐nested polymerase chain reaction for the detection of preleukemic clones at birth.ResultsClonotypic IGH rearrangements were detected in neonatal blood spots of 54.2% of patients (13/24). In two cases with double IGH rearrangements detected at diagnosis, only one rearrangement was present at birth, while in the third case both leukemic rearrangements were detected in neonatal blood. Guthrie card‐positive f...
Introduction. Infections caused by fungi of Fusarium species occur in immunocompromised individua... more Introduction. Infections caused by fungi of Fusarium species occur in immunocompromised individuals as disseminated diseases. Case Report. This case report presents a 5-year-old boy with acute lymphoblastic leukemia who developed a disseminated fusarium infection during reinduction chemotherapy. Fever was the main symptom and it lasted for 15 weeks. Refractory fever despite broad-spectrum antibiotics, as well as nausea, myalgia, pulmonary symptoms with detection of pulmonary infiltrates, liver and spleen involvement indicated an invasive fungal infection. The patient received fluconazole, voriconazole, liposomal amphotericin B and caspofungin. Since high temperature was persistent, diagnostic laparoscopy of the abdomen was done. Scattered lesions, up to 2 mm in diameter, were observed macroscopically on the surface of the liver and spleen. The liver culture was positive for Acinetobacter and Fusarium species. After 38 days of therapy with liposomal amphotericin B and 3 days of cipro...
IntroductionChildhood B‐cell precursor acute lymphoblastic leukemia (BCP‐ALL) can be traced back ... more IntroductionChildhood B‐cell precursor acute lymphoblastic leukemia (BCP‐ALL) can be traced back to birth using leukemic clone‐specific immunoglobulin heavy chain (IGH) rearrangements, implying prenatal origin of this disease.MethodsWe retrospectively analyzed neonatal blood spots (Guthrie cards) of 24 patients with childhood BCP‐ALL aged 1–9.6 years (median 3.1 years) for the presence of clonotypic IGH rearrangements identified in diagnostic bone marrow samples. Based on the sequences of IGH rearrangements, 2 patient‐specific primers were designed for each patient and used in semi‐nested polymerase chain reaction for the detection of preleukemic clones at birth.ResultsClonotypic IGH rearrangements were detected in neonatal blood spots of 54.2% of patients (13/24). In two cases with double IGH rearrangements detected at diagnosis, only one rearrangement was present at birth, while in the third case both leukemic rearrangements were detected in neonatal blood. Guthrie card‐positive f...
Introduction. Infections caused by fungi of Fusarium species occur in immunocompromised individua... more Introduction. Infections caused by fungi of Fusarium species occur in immunocompromised individuals as disseminated diseases. Case Report. This case report presents a 5-year-old boy with acute lymphoblastic leukemia who developed a disseminated fusarium infection during reinduction chemotherapy. Fever was the main symptom and it lasted for 15 weeks. Refractory fever despite broad-spectrum antibiotics, as well as nausea, myalgia, pulmonary symptoms with detection of pulmonary infiltrates, liver and spleen involvement indicated an invasive fungal infection. The patient received fluconazole, voriconazole, liposomal amphotericin B and caspofungin. Since high temperature was persistent, diagnostic laparoscopy of the abdomen was done. Scattered lesions, up to 2 mm in diameter, were observed macroscopically on the surface of the liver and spleen. The liver culture was positive for Acinetobacter and Fusarium species. After 38 days of therapy with liposomal amphotericin B and 3 days of cipro...
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