Papers by Joanna Zawitkowska
Pathogens
Viral infections can be a serious complication of therapy in children with acute lymphoblastic le... more Viral infections can be a serious complication of therapy in children with acute lymphoblastic leukemia (ALL). In this study, we focused on the incidence and the profile of viral infection in children with ALL treated in 17 pediatric oncology centers in Poland in the two-year periods of 2018–2019 and 2020–2021. We also compared the frequency of viral infections in 2018–2019 to that in 2020–2021. In 2020–2021, a total of 192 children with ALL had a viral infection during intensive chemotherapy. A total number of 312 episodes of viral infections were diagnosed. The most common infections detected in the samples were: COVID-19 (23%), rhinovirus (18%), and respiratory syncytial virus (14%). COVID-19 and BK virus infections were the reason for the death 1% of all patients. In 2018–2019, a total of 53 ALL patients who had a viral infection were reported and 72 viral events were observed, mainly adenovirus (48.6%), rotavirus (31.9%), and herpes zoster (8.3%). No deaths were reported during...
BMC Medical Genomics
Background T-cell acute lymphoblastic leukemia is a subtype of acute lymphoblastic leukemia, one ... more Background T-cell acute lymphoblastic leukemia is a subtype of acute lymphoblastic leukemia, one of the most common childhood neoplasms. Hypodiploidy is a chromosome abnormality with fewer than 45 chromosomes and is associated with unsatisfactory clinical outcomes in acute lymphoblastic leukemia. Case presentation We report clinical and genetic findings of a 14-year-old male with T-cell acute lymphoblastic leukemia with low-hypodiploidy. The medical history included neck pain for a month, facial nerve palsy on the right side for 6 days, fever, drowsiness, and weakness for 3 days, vomiting, diarrhea for 1 day. The physical examination presented features of hypovolemia, palsy of the facial nerve on the right side, enlarged lymph nodes, hepatosplenomegaly, sore throat, and petechiae of the skin. Radiological images indicated lesions of different organs. Bone marrow biopsy confirmed precursor T-ALL. In the FISH tests, KMT2A and BCR/ABL1 rearrangements were not observed. GTG banding reve...
International Journal of Molecular Sciences
Immunotherapy is a milestone in the treatment of poor-prognosis pediatric acute lymphoblastic leu... more Immunotherapy is a milestone in the treatment of poor-prognosis pediatric acute lymphoblastic leukemia (ALL) and is expected to improve treatment outcomes and reduce doses of conventional chemotherapy without compromising the effectiveness of the therapy. However, both chemotherapy and immunotherapy cause side effects, including neurological ones. Acute neurological complications occur in 3.6–11% of children treated for ALL. The most neurotoxical chemotherapeutics are L-asparaginase (L-ASP), methotrexate (MTX), vincristine (VCR), and nelarabine (Ara-G). Neurotoxicity associated with methotrexate (MTX-NT) occurs in 3–7% of children treated for ALL and is characterized by seizures, stroke-like symptoms, speech disturbances, and encephalopathy. Recent studies indicate that specific polymorphisms in genes related to neurogenesis may have a predisposition to MTX toxicity. One of the most common complications associated with CAR T-cell therapy is immune effector cell-associated neurotoxic...
Journal of Education, Health and Sport, Mar 31, 2022
The most common malignancy affecting children is leukemia, which in infants refers to be diagnose... more The most common malignancy affecting children is leukemia, which in infants refers to be diagnosed before 1 year of age and is relatively rare, but remains a problem for clinicians due to its aggressive clinical presentation, poor response to current treatments, and molecular biology. Infants with acute leukemia tend to present with aggressive features, including hyperleukocytosis, hepatosplenomegaly, central nervous system (CNS) involvement, and cutaneous infiltration. In infant leukemia, the KMT2A gene rearrangement at chromosome 11q23 is quite common. Infants diagnosed with acute leukemia harboring a 11q23 rearrangement have a particularly poor prognosis when compared to other children with acute leukemia. A 10-month-old girl was admitted in December 2017 to the Department of Pediatric Hematology, Oncology and Transplantology in Lublin with the suspicion of leukemia. One week before hospitalization minor bruises began to appear on the skin, unrelated to an injury. The child was admitted to the hospital, and there a complete blood count showed anemia, hiperleukocytosis and thorombocytopenia. On the admission to the Clinic: the severe general condition of the patient, with features of cardiopulmonary insufficiency were confirmed. Due to the patient's age and the presence of the KMT2A/MLLT3-t(9;11) (p22;q23) gene rearrangement, the infant was stratified as a high-risk group (HRG) and chemotherapy was started in accordance with the therapeutic program. Infant leukemia is one of the most difficult clinical situations encountered in pediatric oncology. Given the infant's vulnerability and unique genetic rearrangements, there is a need to develop new protocols and therapies for infants.
Postepy Nauk Medycznych, Mar 20, 2014
Aleukemic leukemia cutis as a manifestation of acute lymphoblastic leukemia in a 13-year-old girl... more Aleukemic leukemia cutis as a manifestation of acute lymphoblastic leukemia in a 13-year-old girl Aleukemiczna białaczka skóry jako manifestacja ostrej białaczki limfoblastycznej u 13-letniej dziewczynki
Cancers
The view of paediatric cancer as a genetic disease arises as genetic research develops. Germline ... more The view of paediatric cancer as a genetic disease arises as genetic research develops. Germline mutations in cancer predisposition genes have been identified in about 10% of children. Paediatric cancers are characterized by heterogeneity in the types of genetic alterations that drive tumourigenesis. Interactions between germline and somatic mutations are a key determinant of cancer development. In 40% of patients, the family history does not predict the presence of inherited cancer predisposition syndromes and many cases go undetected. Paediatricians should be aware of specific symptoms, which highlight the need of evaluation for cancer syndromes. The quickest possible identification of such syndromes is of key importance, due to the possibility of early detection of neoplasms, followed by presymptomatic genetic testing of relatives, implementation of appropriate clinical procedures (e.g., avoiding radiotherapy), prophylactic surgical resection of organs at risk, or searching for d...
Molecules
Acute myeloid leukemia (AML) accounts for approximately 15–20% of all childhood leukemia cases. T... more Acute myeloid leukemia (AML) accounts for approximately 15–20% of all childhood leukemia cases. The overall survival of children with acute myeloid leukemia does not exceed 82%, and the 5-year event-free survival rates range from 46% to 69%. Such suboptimal outcomes are the result of numerous mutations and epigenetic changes occurring in this disease that adversely affect the susceptibility to treatment and relapse rate. We describe various molecular-targeted therapies that have been developed in recent years to meet these challenges and were or are currently being studied in clinical trials. First introduced in adult AML, novel forms of treatment are slowly beginning to change the therapeutic approach to pediatric AML. Despite promising results of clinical trials investigating new drugs, further clinical studies involving greater numbers of pediatric patients are still needed to improve the outcomes in childhood AML.
Central European Journal of Immunology
International Journal of Molecular Sciences, 2022
Acute lymphoblastic leukemia (ALL) is the most common malignancy among children. Despite the enor... more Acute lymphoblastic leukemia (ALL) is the most common malignancy among children. Despite the enormous progress in ALL therapy, resulting in achieving a 5-year survival rate of up to 90%, the ambitious goal of reaching a 100% survival rate is still being pursued. A typical ALL treatment includes three phases: remission induction and consolidation and maintenance, preceded by a prednisone prephase. Poor prednisone response (PPR) is defined as the presence of ≥1.0 × 109 blasts/L in the peripheral blood on day eight of therapy and results in significantly frequent relapses and worse outcomes. Hence, identifying risk factors of steroid resistance and finding methods of overcoming that resistance may significantly improve patients’ outcomes. A mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK-ERK) pathway seems to be a particularly attractive target, as its activation leads to steroid resistance via a phosphorylating Bcl-2-interacting mediator of cell death (BIM...
Cancers, 2022
One of the most common cancer malignancies is non-Hodgkin lymphoma, whose incidence is nearly 3% ... more One of the most common cancer malignancies is non-Hodgkin lymphoma, whose incidence is nearly 3% of all 36 cancers combined. It is the fourth highest cancer occurrence in children and accounts for 7% of cancers in patients under 20 years of age. Today, the survivability of individuals diagnosed with non-Hodgkin lymphoma varies by about 70%. Chemotherapy, radiation, stem cell transplantation, and immunotherapy have been the main methods of treatment, which have improved outcomes for many oncological patients. However, there is still the need for creation of novel medications for those who are treatment resistant. Additionally, more effective drugs are necessary. This review gathers the latest findings on non-Hodgkin lymphoma treatment options for pediatric patients. Attention will be focused on the most prominent therapies such as monoclonal antibodies, antibody–drug conjugates, chimeric antigen receptor T cell therapy and others.
European Journal of Haematology, 2018
The aim of this study was to analyse the clinical characteristics and outcome of children diagnos... more The aim of this study was to analyse the clinical characteristics and outcome of children diagnosed with Ph+ ALL.
Pediatric hematology and oncology, Jan 17, 2017
Children with Down syndrome (DS) have a 20-fold increased risk of developing leukemia compared wi... more Children with Down syndrome (DS) have a 20-fold increased risk of developing leukemia compared with the general population. The aim of the study was to analyze the outcome of patients diagnosed with Down syndrome and acute lymphoblastic leukemia (ALL) in Poland between the years 2003 and 2010. A total of 1848 children were diagnosed with ALL (810 females and 1038 males). Of those, 41 (2.2%) had DS. The children were classified into three risk groups: a standard-risk group-14 patients, an intermediate-risk group-24, a high-risk group-3. All patients were treated according to ALLIC 2002 protocol. The median observation time of all patients was 6.1 years, and in patients with DS 5.3 years. Five-year overall survival (OS) was the same in all patients (86% vs 86%, long-rank test, p = .9). The relapse-free survival (RFS) was calculated as 73% in patients with DS and 81% in patients without DS during a median observation time (long-rank test, p = .3). No statistically significant differenc...
Pediatria Polska, 2015
Abstract Introduction Vincristine-induced polyneuropathy is a serious clinical problem. According... more Abstract Introduction Vincristine-induced polyneuropathy is a serious clinical problem. According to various sources 40–90% of patients with cancer, undergoing chemotherapy, had symptoms of neuropathy, which may cause dose reduction or even withdrawal from chemotherapy. Aim The aim of this study was to evaluate the prevalence of vincristine-induced polyneuropathy in children with acute lymphoblastic leukemia and analysis of coincidence of other factors on the incidence of this complication. Materials and methods A total of 44 children with acute lymphoblastic leukemia who were treated according to the program ALLIC 2009 were analyzed in the study. Results The symptoms of vincristine-induced polyneuropathy appeared in 86.36% (38/44) of the patients, and 47.36% of them required the use of intensive rehabilitation. It was confirmed that peripheral neuropathy is more often accompanied by other complications, especially haematological and liver toxicity. However, we did not confirm that diabetes and young age can predispose to more frequent appearance of this complication. Our study did not show that cumulation of vincristine dose was the cause of a higher incidence of polyneuropathy. Conclusions Vincristine-induced polyneuropathy is very common complication of treatment of acute lymphoblastic leukemia and it is a serious diagnostic and therapeutic problem in childhood treated for ALL.
Pediatria Polska, 2012
ABSTRACT
Acta Haematologica Polonica, 2012
Cancers
Acute lymphoblastic leukemia is the most common blood cancer in pediatric patients. There has bee... more Acute lymphoblastic leukemia is the most common blood cancer in pediatric patients. There has been enormous progress in ALL treatment in recent years, which is reflected by the increase in the 5-year OS from 57% in the 1970s to up to 96% in the most recent studies. ALL treatment is based primarily on conventional methods, which include chemotherapy and radiotherapy. Their main weakness is severe toxicity, which prompts dose reduction, decreases the effectiveness of the treatment, and, in some cases, can lead to death. Currently, numerous modifications in treatment regimens are applied in order to limit toxicities emerging from conventional approaches and improve outcomes. Hematological treatment of pediatric patients is reaching for more novel treatment options, such as targeted treatment, CAR-T-cells therapy, and immunotherapy. These methods are currently used in conjunction with chemotherapy. Nevertheless, the swift progress in their development and increasing efficacity can lead ...
<strong>Jedlińska Dorota, Kaleta Marcelina, Zawitkowska Joanna, Kościuk Andrzej, Lejman Mon... more <strong>Jedlińska Dorota, Kaleta Marcelina, Zawitkowska Joanna, Kościuk Andrzej, Lejman Monika, Zaucha Prażmo Agnieszka, Drabko Katarzyna. </strong><strong>Multiple complications of the induction phase chemotherapy for childhood acute lymphoblastic leukemia. Journal of Education, Health and Sport. 2019;9(8):121-126. eISNN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3371094</strong> <strong>http://ojs.ukw.edu.pl/index.php/johs/article/view/7267</strong> <strong>The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.</strong> <strong>© The Authors 2019;</strong> <strong>This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland</strong> <strong>Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike.</strong> <strong>(http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.</strong> <strong>The authors declare that there is no conflict of interests regarding the publication of this paper.</strong> <strong>Received: 05.07.2019. Revised: 25.07.2019. Accepted: 19.08.2019.</strong> <strong>Multiple complications of the induction phase chemotherapy for childhood acute lymphoblastic leukemia</strong> <strong>Dorota Jedlińska<sup>1</sup>, Marcelina Kaleta<sup>1</sup>, Joanna Zawitkowska<sup>1</sup>, Andrzej Kościuk<sup>1</sup>, Monika Lejman<sup>2</sup>, Agnieszka Zaucha-Prażmo<sup>1</sup>, Katarzyna Drabko<sup>1</sup></strong> <sup>1</sup>Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, [...]
Address for correspondence/Adres do korespondencji: Dr n. med. Joanna Zawitkowska Klinika Hematol... more Address for correspondence/Adres do korespondencji: Dr n. med. Joanna Zawitkowska Klinika Hematologii i Onkologii Dziecięcej UM w Lublinie Dziecięcy Szpital Kliniczny ul. Chodźki 2, 20–0983 Lublin, Poland tel. 507 365 635; e-mail: [email protected] © ONKOLOGIA I RADIOTERAPIA 2 (4) 2008 Original article/Artykuł oryginalny Powikłania neurologiczne u dzieci z ostrą białaczką limfoblastyczną wyłączając wstępne zajęcie OUN
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Papers by Joanna Zawitkowska