PET/CT is associated with change in staging in approximately 1 out of 3 pediatric patients with HD and NHL. When used for monitoring response to treatment, a negative study is associated with disease-free period, even when residual mass is detected. A positive PET study indicates residual malignant disease.

Although this study has considerable limitations in terms of retrospective design, heterogeneous group of patients and diagnoses, the changing awareness for thrombosis over the last 14 years and the inclusion of symptomatic VTE events only, our surprising data suggest that, as opposed to adults, the risk of clinically significant VTE in children with brain tumors may be exceedingly low. These findings set the stage for future forthcoming evaluations in view of the prospective studies that were done in adults and the possible significant implications for the prevention and possible etiologies of the disease.

The high rate of EGFR gene amplification and protein expression in disseminated pediatric LGGs is intriguing and may have implications for our understanding of the role of EGFR in glioma genesis. Targeted therapies may be available for these children. Larger-scale studies are needed to establish further these findings.

Idiopathic thrombocytopenic purpura (ITP) in childhood is a benign disease, as only 10% to 20% of the patients have a chronic course. A retrospective study of 57 ITP patients ranging in age from four months to two years revealed that 30% of them proceeded to chronicity. Unlike ITP in the general pediatric population, chronic infantile ITP was characterized by male predominance, a high frequency of preceding viral infections, and lack of responsiveness to any of the known modalities of treatment.

SummaryOwing to the increased central nervous system (CNS) relapse risk in T-cell acute lymphoblastic leukaemia (ALL), it is unclear whether preventive cranial radiation (pCRT) can be safely omitted. In this study, pCRT was replaced by extended triple intrathecal therapy (TIT) in prednisone good early responders -medium-risk (MR) group, accounting for 76% of T-ALL patients. From 1989 to 2003, 143 T-ALL patients aged 1-18 years were enrolled in the Israel National Studies (INS) 89 (n = 84) and INS 98 (n = 59) trials, based on ALL-Berlin-Frankfurt-Munster (BFM) 86/90 and ALL-BFM 95 protocols, respectively. Five-year event-free survival (EFS) of the MR group in the INS 89 (n = 60) was 70 ± 5AE9% and the INS 98 (n = 43), 83AE7 ± 5AE6% (P = 0AE12); the cumulative incidence (CI) of any CNS relapse was 5AE0 ± 2AE8% and 2AE3 ± 2AE3% (P = 0AE50), respectively. There was no difference in outcome between MR patients with a white blood cell count (WBC) ‡100 · 10 9 /l treated with extended TIT (n = 17) or pCRT (n = 10).For all T-ALL patients, 5-year EFS was 61AE9 ± 5AE3% in INS 89 and 72AE9 ± 5AE8% in INS 98, (P = 0AE21); the CI of any CNS relapse was 7AE1 ± 2AE8% and 1AE7 ± 1AE7% (P = 0AE142), respectively. Outcome of T-ALL MR patients given extended TIT in the context of BFM-based protocols with long-term follow-up appeared to be comparable to studies in which a larger proportion of patients was irradiated, and was associated with low risk of CNS relapse, regardless of the WBC.