[Respiratory syncitial virus in immunocompromised patients in a pediatric hospital: 5 years experience]. / Infección por virus respiratorio sincitial en los pacientes inmunodeprimidos en un hospital pediátrico: experiencia de 5 años.

INTRODUCTION: Respiratory syncytial virus (RSV) infection is associated with an increase in morbidity and mortality in immunocompromised hosts. METHODS: A description is presented of all cases of RSV infection in immunocompromised pediatric patients in Hematology and Oncology and Immunodeficiency Units between 2008 and 2012. RESULTS: Nineteen patients were diagnosed with RSV infection. Nine patients required in-patient care and 2 required Pediatric Intensive Care Unit. Five patients were treated with specific therapy (ribavirin ± palivizumab). No deaths occurred in the study period. CONCLUSION: RSV infection may be severe in immunocompromised pediatric patients.

[Musculoskeletal pain: a common initial sign of acute lymphoblastic leukaemia]. / Dolor musculoesquelético: una forma de inicio frecuente de leucemia linfoblástica aguda.

Musculoskeletal pain is a common complaint in paediatrics usually due to benign diseases. Nevertheless neoplasms, particularly acute leukaemia, must be considered in the differential diagnosis. During the last 9 months 4 of the 9 patients diagnosed with acute leukaemia at our hospital presented with a limp, arthralgias, lumbar or bony pain. We describe these cases and review the clinical and analytical parameters that help to differentiate benign pain from that associated with a malignant disease. The early detection of these processes may represent a significant improvement in their prognosis.

[Primary lung tumors]. / Tumores broncopulmonares primarios.

Pulmonary neoplasia in children is usually due to methastatic disease because primary lung tumors are very unfrequent. Due to its' rarity they are usually not included in the differential diagnosis of lung masses, so treatment is delayed and prognosis is worsened. Herein, we show our experience in the management of five primary tumors of the lung or the airway: one tracheal, three bronchial, and another intraparenchymatous. We study the clinical behaviour, diagnostic work-up, treatment, histology, and follow-up. Despite its rarity, a diagnosis of pulmonary tumor should be considered in any child with respiratory symptoms that does not improve with standard therapy. An early and accurate diagnosis and an adequate treatment are crutial in the prognosis of these patients.

[Aggressive fibromatosis in childhood: retrospective analysis of four cases]. / Fibromatosis agresiva en la infancia: análisis retrospectivo de 4 casos.

OBJECTIVE: Aggressive fibromatosis is a rare illness in children. We analyzed the records of four patients, taken from a total of 505, all of which had different types of tumours, over a period of ten years. In the four cases, three were male and one female. Their ages ranged from 0-7 years old. We also did a review of this pathology. RESULTS: The illness may present itself a a painless mass found particularly in the pelvic area, knee, buttock and anterior mediastinum, respectively. Two of these cases presented lysis of osseous tissue shown in radiologic assays. The diagnosis was histological in every case. The only treatment was surgical in all of them. Two of the cases required only one intervention to achieve remission and up to now there has been no record of further illness. At the time of writing this paper the patients are alive after a follow-up period of thirty months. CONCLUSIONS: Up to now, no other alternative forms of treatment have been convincing. Adjuvant radiation and chemotherapy are probably beneficial, but the precise indication for its use is not well defined.

[The treatment results in children diagnosed with non-Hodgkin's lymphomas and acute B-cell lymphoblastic leukemias treated by the BFM protocols. The report of the POGM (Pediatric Oncology Group of Madrid)]. / Resultados del tratamiento de niños diagnosticados de linfomas no Hodgkin y leucemias linfoblásticas agudas de células B tratados con protocolos BFM. Informe del GOPM (Grupo de Oncología Pediátrica de Madrid).

OBJECTIVE: The purpose of this study was to reproduce the results obtained by the "BFM Group" in children with NHL and B-ALL treated with BFM 86 and 90 protocols. PATIENTS AND METHODS: From April 1987 until January 1997, we have treated a total of 82 children, 22 with non-B NHL, 49 B-NHL and 11 B-ALL. Forty-four of them were treated according to BFM 86 and 38 according to BFM 90 protocols. RESULTS: Ninety-four percent of the patients achieved complete remission (CR) and 15% of these relapsed, 12% of the cases of B NHL/ALL and 23% of the non-B NHL. The 5 year overall survival (Kaplan Meier) was 81% for the B NHL/ALL it was 83% and for non-B NHL 77%. The event-free survival was 75% for B-NHL, stages I and II it was 80% and stages II and IV 78%, for B-ALL 72% and for non-B NHL 68%. The median follow-up time was 50 months (12-106). CONCLUSIONS: Treatment of NHL and B-ALL with BFM protocols is an effective therapeutic choice, with reproduction of the results of the "BFM group" being feasible.

[The treatment results in children with malignant mesenchymal tumors according to the protocols of the International Society of Pediatric Oncology (SIOP)]. / Resultados del tratamiento de niños con tumores mesenquimales malignos según protocolos de la Sociedad Internacional de Oncología Pediátrica (SIOP).

OBJECTIVE: To evaluate the SIOP protocols in the treatment of mesenchymal tumors. PATIENTS AND METHODS: We present the results obtained in 28 children diagnosed at a single pediatric hematology-oncology unit of having malignant mesenchymal tumors. These diagnoses were made between April 1981 and June 1994 and the children were treated following the consecutive SIOP protocols which have the objective of curing the disease with minimal sequelae. The first four patients with rhabdomyosarcoma were treated with MMT-SIOP 75, the next 9 children, also diagnosed with rhabdomyosarcoma, were treated with MMT-SIOP 84. During the same period of time, there was a case of synovial sarcoma treated only with surgical excision. The last 14 patients were included in the current protocol, initiated in 1989. Eleven of these patients had rhabdomyosarcoma and 3 synovial sarcoma. RESULTS: Overall survival and event-free survival at 5 years were 58% and 36%, respectively. Toxicity never was an important factor, although it was increasingly frequent and severe as protocols evolved. CONCLUSIONS: We conclude that our results are similar to those obtained in patients treated with SIOP protocols.

[The results of treatment by the Madrid Pediatric Oncology Group according to the BFM protocols in non-Hodgkin's B-cell lymphoma and acute B-cell lymphoblastic leukemia in pediatric patients]. / Resultados del tratamiento según protocolos BFM del linfoma no Hodgkin B y de la leucemia linfoblástica aguda de células B en pacientes pediátricos por el GOPM.

The objective of this report is to present the results of the BFM group in the treatment of 41 children with non-Hodgkin's B cell lymphoma and acute B cell lymphoblastic leukemia according to the BFM 86 and 90 protocols. Forty-one children, between 2 and 16 years of age, were treated from November 1987 to October 1993. Of these, 25 were treated with the BFM 86 protocol (18 non-Hodgkin's B cell lymphomas and 7 acute B cell lymphoblastic leukemias) and the rest with the BFM 90 protocol (15 non-Hodgkin's B cell lymphomas and 1 acute B cell lymphoblastic leukemia). Complete remission was achieved in 97.5% of the patients. A relapse occurred in 12.5% of the cases. Currently, 80.4% remain in continuous complete remission and 17% have died. The 5 year actuarial survival rate of those treated with the BFM 86 and 90 protocols was 79% and 87%, respectively, and event free survival in the same period was 76% and 87%, respectively. There was no statistically significant difference in the results obtained with the two treatment protocols.

[Acute lymphoblastic leukemia: comparison of traditional treatment with intensive therapy methods]. / Leucemia linfoblástica aguda: comparación de los resultados del tratamiento clásico con terapias intensivas.

In this study we compare two different therapies for the treatment of non-B acute lymphoblastic leukemia (ALL). Forty-four children diagnosed as having non-B ALL were treated by one of two methods: 20 children were treated from 1981 to 1984 according to the PETHEMA 7/78 protocol and 24 children were treated from 1984 to 1987 following the BFM 83 protocol. These treatments differ in that BFM 83 includes a higher number of cytostatics, uses intravenous methotrexate at moderate doses as "reservoirs" treatment and a lower dose of holocranial radiotherapy. The BFM 83 treatment resulted in a significant improvement in survival (48% versus 92% p < 0.05), as well as in the absence of further events (45% versus 88%, p < 0.01).

[Adenovirus infections in an emergency department]. / Infecciones por adenovirus en un servicio de urgencias.

We have reviewed 108 emergency ward reports of patients with adenoviral positive cultures in "Doce de Octubre" Hospital in Madrid. Our aim was to know the most frequent symptoms of the infection so that identification and treatment could be managed more efficiently in our department. Cellular cultures were negative for other viruses such as CMV, enterovirus and herpesvirus. No bacteria were found in the throat cultures. Of the children who were evaluated, 78% were younger than 3 years old. The most frequent symptom was high fever with an otherwise good state of health. During the physical examination, a reddened throat with an exudate was found in half of the patients. A white blood cell count of over 15,000 was found in 33% of the patients with a left shift in 20%. The clinical findings overlapped with throat bacterial infections in 66%, lower respiratory infections in 14%, and more unusual, gastroenteritis, hematuria, intestinal invagination or exanthemas. Only 15% were not given antibiotic therapy.

[Review of 54 cases of idiopathic thrombocytopenic purpura. Evaluation of the response to treatment]. / Revisión de 54 casos de púrpura trombocitopénica idiopática. Valoración de la respuesta al tratamiento.

Fifty four cases of idiopathic thrombocytopenic purpura with an evolution longer than six months are reported. Total remission was achieved in 96.2% of patients, half of them without treatment. Etiologic agent, clinical features and response to different ways of treatment are analyzed.