Systemic viral diseases frequently occur in allogeneic hematopoietic stem cell transplantation, but data in children receiving chemotherapy for acute leukemia are scarce. We therefore collected and analyzed the published data on symptomatic infection from cytomegalovirus, herpes simplex virus, varicella zoster virus, parvovirus B19, or adenovirus in pediatric acute leukemia. Reports on 68 children were identified, of whom 16 patients have died from the infection. Further studies have to (1) evaluate the true incidence of these infections in pediatric acute leukemia, (2) their impact on outcome, and (3) whether a subpopulation of patients could benefit from screening and prophylactic strategies. K E Y W O R D S acute leukemia, adenovirus, child, cytomegalovirus, herpes simplex virus, parvovirus B19, systemic viral disease, varicella zoster virus We performed a MEDLINE (including MEDLINE In Process) search to identify relevant English-language articles indexed from January 1, 2000, up to December 31, 2019. The search included a combination of indexed terms and free text terms (child OR adolescent OR pediatr*); (cancer OR malignancy OR leukemia); (parvovirus OR b19)/(adenovirus)/(varicella or VZV)/(cytomegalovirus or CMV)/(herpes simplex virus or HSV). The hits were screened manually by two of the authors (CBG and TL). Only case reports and case series about systemic infections or studies on the prevalence of viremia with CMV, HSV, VZV, PVB19, and ADV, respectively, occurring in children

Tumors of the central nervous system represent the largest group of solid tumors found in pediatric patients. Pilocytic astrocytoma is the most common pediatric glioma, mostly located in the posterior fossa. The majority of brainstem tumors, however, are classified as highly aggressive diffuse intrinsic pontine gliomas (DIPGs) and their prognosis is dismal.The authors report on the case of a neonate in whom MRI and neuropathological assessment were used to diagnose DIPG. Before initiation of the planned chemotherapy, the tumor regressed spontaneously, and the newborn exhibited a normal neurological development. Meanwhile, Illumina Human Methylation450 BeadChip analysis reclassified the tumor as pilocytic astrocytoma of the posterior fossa.In conclusion, the authors advocate not initiating immediate intensive therapy in newborns with brain tumors, even with classical appearance of a DIPG; rather, they would like to encourage a biopsy to define the best individual therapeutic approach and avoid ineffective chemotherapy.

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