Finding predictors of chronic graft-versus-host disease (cGVHD) in children would be extremely useful. Because of recent data suggesting that cGVHD may be a Th-2-mediated process, a theoretical foundation linking eosinophilia and cGVHD exists. While an association between eosinophilia and cGVHD has been described in adults, it has never been described in children. We studied 53 patients that received allogeneic hematopoietic stem cell transplants (SCT) between 1999 and 2002. Ten (19%) of these patients developed eosinophilia (absolute eosinophil count (AEC) > 500x 10/L) after day 100. Of these ten, eight either had or later developed cGVHD. We conclude that following the peripheral eosinophil count in children post-SCT is useful, and a rise in the AEC may herald the development of cGVHD. Taking the AEC into account with other risk factors (such as previous grade II-IV acute GVHD, human leukocyte antigen (HLA)-mismatch, and unrelated donor (URD) transplant) may improve our ability to predict cGVHD.

Young children with cancer are a therapeutic challenge both in terms of chemotherapeutic efficacy as well as toxicity. The ontogeny of each drug differs, and hence, general rules cannot easily apply. Each drug should be studied by itself before rational cancer therapy for young children can be offered. Much more focus on this age group is needed to improve survival, while ensuring their long-term quality of life of these children.

Two unique FANCA mutations and one FANCG mutation were identified in Israeli Arab FA patients. Deletion of FANCA exon 6-31 as in previously described gross deletions was within introns rich in Alu repeats. To the best of our knowledge, the FANCA IVS 42-2A>C mutation is the first in this gene to result in intron retention. Further analysis of FA mutations will enable prenatal diagnosis and a rational therapeutic approach including frequent monitoring and early bone marrow transplantation.

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