Papers by Katarzyna Muszynska-roslan
Medycyna wieku rozwojowego
We report 6 children, aged 4.5- 16 years, with acute lymphoblastic leukaemia with back pain, exac... more We report 6 children, aged 4.5- 16 years, with acute lymphoblastic leukaemia with back pain, exacerbated by walking as the first symptom of disease. Collapse of the vertebral bodies at multiple levels was shown on imaging. The presented group had good prognosis. In densitometric examination of BMD (bone mineral density) was observed loss in the thoracic and lumbar vertebrae in 5 out of 6 children. Chemotherapy resulted in decrease of pain and spontaneous remodelling of the vertebrae.
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Medycyna wieku rozwojowego
One of the side effects of antineoplastic treatment is immunosuppression. A consequence of this a... more One of the side effects of antineoplastic treatment is immunosuppression. A consequence of this are frequent infections, sometimes with fatal outcome. The immunological system "answers" to infections with changes in number and quality of cells participating in the inflammatory process. The aim of the study was to investigate the subpopulations of mononuclear cells in patients with neoplastic (haematologic) diseases during infections. We studied 16 children with acute lymphoblastic leukaemia and with lymphomas (Hodgkin and non-Hodgkin). Among our patients we note 25 episodes of infections requiring hospitalization. Mean percent values of mononuclear antibodies: CD14-PE/CD45-FITC, CD3-FITC/CD19-PE, CD4-FITC/CD8-PE, CD3-FITC/CD16+CD56-PE, CD14-PerCP/CD54-PE, CD3-PerCP/CD54RA-FITC/CD45RO-PE, CD3-PerCP/HLA-DR, CD14-PerCP/HLA-DR. In the examination carried out during acute infection, we found higher mean percent values of CD3+ HLDAR+, CD14+ CD54+ and CD3+ CD45RO+ cells than in a...
memo - Magazine of European Medical Oncology, 2013
Since 1983 four consecutive unified regimens: acute myeloid leukemia-Polish pediatric leukemia/ly... more Since 1983 four consecutive unified regimens: acute myeloid leukemia-Polish pediatric leukemia/lymphoma study group (AML-PPLLSG) 83, AML-PPLLSG 94, AML-PPLLSG 98 and AML-BFM 2004 Interim, for AML have been conducted by the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG). In this paper, we review four successive studies on the basis of acute myeloid leukemia-Berlin-Frankfurt-Munster (AML-BFM) protocol, in which a stepwise improvement of treatment outcome was observed. Treatment results of the last protocol AML-BFM 2004 Interim are presented in detail. Three hundred and three patients with de novo AML were treated according to the AML-BFM 2004 Interim at 15 Polish centers from January 1, 2005 to June 30, 2011. A confrontation with previous treatment periods was based upon historical, already published data. In four consecutive periods, 723 children were eligible for evaluation (208, 83, 195, and 237, respectively). Complete remission rates in consecutive periods were: 71, 68, 81 and 87 %, respectively. The 5-year overall survival rates, event-free survival rates, and relapse-free survival rates were 33, 32, and 45%, respectively for AML-PPLLSG 83 regimen; 38, 36, and 53 % respectively for AML-PPLLSG 94 regimen; 53, 46, and 65 % respectively for AML-PPLLSG 98 regimen, and 63, 52, and 64 % for AML-BFM Interim 2004, respectively. Incidence of early deaths and that due to complications (mainly infections) in the first remission decreased over time from 22 to 4.6 % and from 10 to 5.9 %, respectively. Despite continuous improvement in the treatment outcome, the number of failures still remains too high. Further progress seemed to be possible due to continued cooperation of oncology centers within large international study groups.
Advances in Medical Sciences, 2014
To assess skeletal mass in survivors of childhood Hodgkin disease (HD) and non-Hodgkin lymphoma (... more To assess skeletal mass in survivors of childhood Hodgkin disease (HD) and non-Hodgkin lymphoma (NHL) 1-5 years after treatment, and to identify potential risk factors influencing bone mineral density (BMD). This cross-sectional study was conducted in a cohort of 43 survivors (HD=31; NHL=12); mean age: 16.21 ± 4.4. Total body bone mineral content (TBMC) and density (TBBMD), and lumbar spine density (LSBMD) were determined using dual-energy X-ray absorptiometry. Three of all 43 patients developed low BMD. No significant differences in height, weight, and/or BMD Z-scores were found between HD and NHL survivors, children who received and did not receive radiotherapy, and the groups with different chemotherapeutic blocks. No differences were noted between the Z-scores of BMC (mean ± SD: 0.31 ± 1.29 vs. -0.089 ± 0.61, p=0.165), TBBMD (mean ± SD: -0.32 ± 1.21 vs. -0.27 ± 0.91, p=0.76), or the LSBMD (mean ± SD: -0.183 ± 1.54 vs. -0.17 ± 0.87, p=0.637) in subgroups, in accordance with time after therapy (subgroup I<2 years and subgroup II>2 years after treatment). In HD survivors, age at diagnosis only affected the TBBMD Z-score (a decrease of 0.127 in total BMD Z-score per each year, R²=0.999, p<0.001). Childhood lymphoma survivors demonstrate no significant deficits in bone mass and tend to maintain their BMD within the normal range when presenting during one to five years' follow-up. However, this specific group requires longitudinal investigation to assess the pattern of peak bone mass achievement and the risk of future bone loss.
Pediatrics International, 2011
Pediatric Blood & Cancer, 2009
memo - Magazine of European Medical Oncology, 2012
Background Since 1983 four consecutive unified regimens: acute myeloid leukemia-Polish pediatric ... more Background Since 1983 four consecutive unified regimens: acute myeloid leukemia-Polish pediatric leukemia/lymphoma study group (AML-PPLLSG) 83, AML-PPLLSG 94, AML-PPLLSG 98 and AML-BFM 2004 Interim, for AML have been conducted by the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG). In this paper, we review four successive studies on the basis of acute myeloid leukemia-Berlin-Frankfurt-Munster (AML-BFM) protocol, in which a stepwise improvement of treatment outcome was observed. Treatment results of the last protocol AML-BFM 2004 Interim are presented in detail. review Development of treatment and clinical results in childhood acute myeloid leukemia in Poland 55 1 3
Pediatric Hematology-Oncology, 2006
... Ma??gorzata Sawicka-Zukowska 1 , Lidia Kajdas 2 ... Acta Oncol 1998; 37: 175???177, [INFOTRIE... more ... Ma??gorzata Sawicka-Zukowska 1 , Lidia Kajdas 2 ... Acta Oncol 1998; 37: 175???177, [INFOTRIEVE], [CSA], [CROSSREF]. Motomura G, Yamamoto T, Miyanishi K, Yamashita A, Sueishi K, Yukihide I. Bone marrow fat-cell enlargement in early steroid-induced osteonecrosis: a ...
Pediatric Hematology-Oncology, 2010
In this study the authors addressed the question whether neurotoxicity due to the chemotherapy of... more In this study the authors addressed the question whether neurotoxicity due to the chemotherapy of acute lymphoblastic leukemia (ALL) is associated with cerebrospinal fluid (CSF) oxidative stress. Examination of 38 ALL patients revealed significant increases in 8-isoprostane concentration and important decreases in total antioxidative capacity of CSF during therapy. The mean 8-isoprostane level at diagnosis was 9.05 +/- 1.62 pg/mL, and no correlations with initial leukocytosis, organomegaly, and lactate dehydrogenase levels were noted. 8-Isoprostane concentrations were increased on the 59th day of treatment (mean level: 24.85 +/- 7.59 pg/mL [P < .01]) and remained elevated at 4 points of the consolidation phase (17.28 +/- 2.16 pg/mL [P < .05]; 22.72 +/- 6.04 pg/mL [P < .05]; 24.92 +/- 6.31 pg/mL [P < .01]; 32.32 +/- 7.94 pg/mL [P < .01]) as compared to their level at diagnosis. The mean total antioxidative capacity at diagnosis was 203.08 +/- 6.17 mumol/L and was remarkably decreased on the 59th day of treatment (189.76 +/- 1.9 mumol/L [P < .05]) and at one point of the consolidation phase (188.29 +/- 3.46 mumol/L [P < .05]) as compared to the level at diagnosis. This study indicates that neurotoxicity of standard ALL treatment may be related to oxidative stress.
Pediatric Blood & Cancer, 2007
Pediatric Blood & Cancer, 2007
The number of survivors of childhood cancer has increased. Several studies in children and adults... more The number of survivors of childhood cancer has increased. Several studies in children and adults have shown relationships between lean mass (LM), fat mass (FM), and bone mineral content (BMC). The objective of the study was to examine the association between body composition and bone mass in young survivors of childhood cancer. Sixty-eight postpubertal participants (31 females and 37 males) aged between 15.5 and 27 years who were at least 5 years after completion of treatment for leukemia (n = 30), lymphoma (n = 28), or solid tumors (n = 10) were studied. Anthropometry was performed and dual energy X-ray absorptiometry (DXA) was used to assess BMC in the total body (T) and lumbar spine (S), FM, and LM. There were no observed differences in age or time for cessation of treatment. Body mass index (BMI) was a strong determinant of bone mass in both sexes. TBMC correlated positively with LM (males r = 0.9 and females r = 0.76; P < 0.0001, respectively) and with FM (r = 0.54; P < 0.01 in males and r = 0.8; P < 0.00001 in females). SBMC correlated with LM in both sexes (in males r = 0.77 and in females r = 0.64; P < 0.0001, respectively) but only in females, SBMC also correlated positively with FM (r = 44 P = 0.03). There were no differences between patients who received radiation and those who did not. The associations between bone mass and body composition differ by sex and skeletal site, however, they are similar in survivors of childhood cancer and compared to healthy individuals during growth. Further prospective research is needed in cancer survivors to determine the long-term effect of anti-cancer therapy on body composition and bone mass.
Medical and Pediatric Oncology, 2002
Medical and Pediatric Oncology, 2001
Neuropediatrics, 2009
The aim of this study was to ascertain whether changes in the concentrations of cerebrospinal flu... more The aim of this study was to ascertain whether changes in the concentrations of cerebrospinal fluid excitatory amino acids (EAAs) contribute to neurotoxicity of the standard acute lymphoblastic leukaemia (ALL) treatment protocols. We found a statistically significant increase in glutamate and aspartate in 12 ALL patients during their treatment. Cognitive functioning was examined in all patients at an average of 3.7 years after the disease diagnosis. Importantly, the levels of EAAs during the therapy were not correlated with the results of the cognitive test. This study suggests that standard ALL treatment-induced neurotoxicity may not lead to persistent neurocognitive deficits.
Neuropediatrics, 2011
The aim of the study was to investigate the levels of cerebrospinal fluid (CSF) cytokines during ... more The aim of the study was to investigate the levels of cerebrospinal fluid (CSF) cytokines during chemotherapy of acute lymphoblastic leukaemia (ALL). Examination of 12 ALL child (6 boys and 6 girls) patients evidenced significant increases in interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) after induction treatment and significant increases in IL-6, tumour necrosis factor-α (TNF-α) and MCP-1 levels during the consolidation phase, as compared to their values at the time of diagnosis. There were no significant differences in CSF IL-6, TNF-α and MCP-1 concentrations after therapy. Our data suggest that standard ALL treatment may cause a subclinical inflammation and neurotoxicity.
Journal of Clinical Densitometry, 2012
Childhood acute lymphoblastic leukemia (ALL) survivors represent a specific group at risk for man... more Childhood acute lymphoblastic leukemia (ALL) survivors represent a specific group at risk for many health problems, including skeletal complications and osteoporosis. The objective of this study was to assess the risk of osteoporosis associated with the prevalence of low bone mass (according to the guidelines of the Pediatric Official Positions of the International Society for Clinical Densitometry 2007) in survivors of childhood ALL. The cross-sectional study was conducted in a cohort of 69 Caucasian children and adolescents (46 boys and 23 girls) aged 12.15 ± 0.5yr diagnosed with ALL and screened up to 5 yr after cessation of the treatment. Total body bone mineral content (TB BMC, g), total body bone mineral density (TB BMD, g/cm(2)), and lumbar spine BMD (LS BMD, g/cm(2)) were determined using dual-energy X-ray absorptiometry. Time interval from the completion of the treatment to the beginning of this study (subgroup I<2 yr or subgroup II>2 yr after treatment), methotrexate (MTX) doses (subgroup I-MTX ranging from 0.5 to 1.0g/m(2); subgroup II-MTX>2.0 g/m(2)), cranial irradiation (subgroup I-without radiotherapy (RTX) and subgroup II receiving RTX of 12-18 Gy), cumulative steroid dose, and impaired endocrine function were considered as potential factors affecting bone metabolism and included in the analysis. No differences were found in bone traits (BMC, TB BMD, LS BMD) in relation to examined risk factors. In multiple regression model that included therapeutical factors, a risk group and central nervous system irradiation were of an important influence on bone mass, and risk group predicted TB BMD in small degree. Risk group and irradiation status lost their significance after the inclusion of anthropometric, age-connected, and time-connected factors. This study suggests that ALL survivors are not at increased risk for low bone mass. However, from the clinical perspective all patients after childhood ALL should be screened for clinical signs, fracture history, and lifestyle risk factors for low bone mass and osteoporosis. They should be referred to bone density evaluation only as often as may be necessary from the clinical evaluation.
Hematological Oncology, 2011
Anaplastic large cell lymphoma includes a subset of highly aggressive tumours and has a relapse r... more Anaplastic large cell lymphoma includes a subset of highly aggressive tumours and has a relapse rate of 30% at 2 years. Relapsed patients often have poor clinical outcome. The use of antisense oligonucleotides to down-regulate Bcl-2 protein can reverse chemotherapy resistance. The authors describe an 11-year-old boy with recurrent anaplastic large cell lymphoma who had received double high-dose chemotherapy followed by autologous haematopoietic stem-cell transplantation, had refractory disease and then had achieved long-term remission with the use of an antisense oligonucleotides in combination with vinblastine and topotecan. Copyright © 2011 John Wiley & Sons, Ltd.
Folia Histochemica et Cytobiologica, 2012
Total antioxidant status (TAS), and the influence of treatment and correlation between TAS and pa... more Total antioxidant status (TAS), and the influence of treatment and correlation between TAS and parameters involved in metabolic syndrome (MS) in pediatric cancer survivors were evaluated. One hundred children and adolescents were studied. Twenty-five survivors received radiotherapy, 12 were obese or overweight.Additionally, we analyzed TAS in eight children with acute lymphoblastic leukemia (ALL) at diagnosis and during treatment after remission induction. The control group consisted of 22 healthy children. Serum concentrations of TAS, glucose, cholesterol, HDL-cholesterol, triglycerides, fibrinogen and insulin were measured. In cancer survivors, independently of diagnosis and kind of treatment (radiotherapy anthracyclines administration),the mean serum TAS did not differ significantly from the control group. No correlations were observed with age at the time of diagnosis or interval after the end of treatment. TAS values did not correlate with traits of the metabolic syndrome. In a group of eight patients with ALL at diagnosis and after induction of remission,TAS values were lower than in the control and cancer survivor groups. Antioxidant status was not found to be deteriorated in children after anticancer treatment, irrespective of diagnosis or kind of treatment, which might indicate sufficient antioxidant prevention. However, the possibility of the development of MS and cardiovascular disease in adulthood indicates the need for future studies.
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Papers by Katarzyna Muszynska-roslan