Is creatine kinase a valid aid in early cardiac muscle damage detection during treatment for childhood acute lymphoblastic leukemia? A case report Grazia Fazio, Jari Intra, Orsola Montini, Laura Rachele Bettini, Giacomo Gotti, et al. Frontiers in Oncology, 2026 Creatine kinase (CK) is an enzyme that plays a pivotal role in various physiological processes, including metabolism and muscle function. This enzyme is found in high concentrations in skeletal muscle and the myocardium, with lower levels present in the brain. Increases in CK values have been observed in muscle damage and neuromuscular disorders. The potential for cardiotoxicity resulting from the administration of chemotherapeutic agents has been identified in subjects affected by hematological or solid tumors. In the present work, we describe the case story of a child diagnosed with acute lymphoblastic leukemia who exhibited two episodes of asymptomatic, markedly elevated CK values, identified during chemotherapy treatment. Our aim was to investigate the potential of CK as a biomarker for the early detection of cardiac muscle damage during therapy.
INTERIM RESULTS OF THE QUESTIONNAIRE ON PREDISPOSITION TO ACUTE LYMPHOBLASTIC LEUKEMIA IN THE AIEOP-BFM ALL 2017 PROTOCOL Giovanni Cazzaniga Haematologica, 2026 About 8–10% of pediatric cancers are associated with pathogenic variants in cancer predisposition genes. In acute lymphoblastic leukemia (ALL), suspicion of predisposition arises from a family history of early-onset tumors, prior malignancies, comorbidities, or known genetic syndromes.Children enrolled in the AIEOP-BFM ALL 2017 protocol completed a short questionnaire (Diagnosis Form 2) to identify clinical features suggestive of cancer predisposition.Among 1,415 patients, 208 (14.7%) met at least one criterion for suspected predisposition. Of these, 64 (31%) had a family history of early-onset cancer (<45 years). A first-degree relative was affected in 41 cases, while 18 reported ≥2 relatives with malignancies and 14 had ≥2 second-degree relatives involved. The most frequent cancers in first-degree relatives included breast (9), thyroid (6), hematologic malignancies (7; 5 ALL, 2 AML), melanoma (5), bladder (2), and brain tumors (2), alongside single cases of other solid tumors.Fifty-two patients (25% of the 208) had a known genetic condition at enrollment. Thirty-seven carried a cancer predisposition syndrome: 30 with Down syndrome, 3 with neurofibromatosis type 1, 2 with Noonan syndrome, 1 with Shwachman-Diamond syndrome, and 1 with a germline RB1 pathogenic variant. Additional comorbidities included congenital malformations (28; 13%) and neurodevelopmental disorders (20; 9.6%).Genetic counseling was recommended for 153 children (11% of all enrolled). Continued collection of consultation outcomes is needed to clarify predisposition conditions, support centralized counseling and genetic testing, and ensure consistent diagnostic approaches and follow-up for affected patients.
Policy of pediatric oncology drug development Lenneke Schrier, C. Michel Zwaan, Carmelo Rizzari, Nicole Scobie, Gregory Reaman, et al. Essentials of Translational Pediatric Drug Development from Past Needs to Future Opportunities, 2024
Practice of pediatric oncology drug development Lenneke Schrier, Andy Pearson, Carmelo Rizzari, Alwin Huitema, Nicole Scobie, et al. Essentials of Translational Pediatric Drug Development from Past Needs to Future Opportunities, 2024
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