Aleksandra Wieczorek

Jagiellonian University

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Walentyna Balwierz

Jagiellonian University

Katarzyna Pawińska-Wąsikowska

Uniwersytecki Szpital Dziecięcy

Szymon Skoczeń

Jagiellonian University

Marek Ussowicz

Wroclaw Medical University

Jacek Wachowiak

Poznan University of Medical Sciences

Paweł Kukołowicz

The Maria Sklodowska-Curie National Research Institute of Oncology

Wojciech Młynarski

Medical University of Lodz

Holger N. Lode

Universitätsmedizin Greifswald

G Krasomski

King's College London

Tomasz Szczepański

Medical University of Silesia

Cooperative Institutions

Jagiellonian University

Uniwersytecki Szpital Dziecięcy

Centrum Onkologii

Medical University of Silesia

Wroclaw Medical University

The Maria Sklodowska-Curie National Research Institute of Oncology

Medical University of Warsaw

Gdańsk Medical University

Lublin Oncology Center

Poznan University of Medical Sciences

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[Evaluation of the myelograms in acute leukemias in children treated at the District Special Hospital for Children in Opole during 1962-1964].

PubMed (1967)

Aleksandra Wieczorek

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OP21.04: Obstetrical outcome in 80 pregnancies with prenatally diagnosed hypoplastic left heart syndrome (HLHS) at a referral center

Ultrasound in Obstetrics and Gynecology (2009)

Aleksandra Wieczorek Maria Respondek‐Liberska G Krasomski J Wilczyński Przemysław Oszukowski

The aim of this study was to report the obstetric outcome of 80 pregnancies with prenatally diagnosed HLHS at a referral center. A retrospective analyses of 80 deliveries in years 1999–2008 in our institution. Terminations of pregnancies or intrauterine fetal death were excluded from analysis. Fetal echocardiography was performed at a mean 32 (19–40) week of gestation. Mean maternal age was 28 (19–41) years old. 23 (29%) of the gestations were high risk. Extracardiac malformations were found in 16 (20%) fetuses and neonates. Only 6 fetuses had karyotype: 4 were normal, there was one case of trisomy 18, and one neonate had a karyotype gender inconsistent with the phenotype. Out of 80 newborns 38 (48%) were delivered vaginally and 42 (52%) by Cesarean section. The labor occurred at a mean 38.2 (30–40) weeks of gestation (at a mean of 6 weeks after diagnosis). 61 (80%) of the neonates were born at term and 19 (20%) preterm. They had mean Apgar score of 8.1 and 7.9 at the 1st and 5th minutes of life, respectively. The mean birth weight was 3030 (1100–4080) gm. 51 (68%) of the neonates were male. The high percentage of Cesarean sections in pregnancies with a prenatal diagnosis of HLHS suggests the need for more extensive prenatal heart hemodynamic evaluation, not only to diagnosed the anatomic type of HLHS but to evaluate its haemodynamic consequences closer to term, to better choose the time and method of delivery.

Apgar score

Fetal echocardiography

10.1002/uog.6858

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[Treatment results of children with neuroblastoma: report of Polish Pediatric Solid Tumor Group].

Walentyna Balwierz Aleksandra Wieczorek Tomasz Klekawka Katarzyna Garus K Bolek-Marzec

Approximately 60 children aged 0-18 years are diagnosed of NBL each year in Poland. About 60% of all patients suffering from NBL have a chance for durable cure. Unfortunately the prognosis for patients within the high-risk group accounting for more than 50% of all NBL patients remains poor despite the introduction of more intensive chemotherapy regimens with radical surgery procedures and megachemotherapy with subsequent stem cell transplantation. Only one third of patients in this group can be cured. To improve the treatment results of the high-risk patient group and to decrease the rate of therapy related side effects current European treatment protocols have been introduced systematically in Poland. In February 2009 information about 389 patients (age 0.1-16.5 years) diagnosed between 2001 and 2008 were obtained. Results of therapy of 319 patients who started treatment from 2001 to 2007 were analyzed. Between 104 infants and 215 children over 1 year of age, stage 4 of disease was found in 25% and 54.5%, respectively. In this period additionally to European treatment protocols, two another protocols were used. Satisfactory treatment results were obtained in 104 infants (5-year event free survival /EFS/=82.6%), irrespective of the type of treatment protocol. Over 5-year EFS for children over 1 year of age in 1, 2 and 3 stage of disease was: 100%, 86.3% and 64.5%, respectively. On the contrary, 107 patients with 4 stage of disease achieved the 5-year EFS of 27% only. Treatment results obtained in patients treated according to the European HR-NBL-1/ESIOP protocol were better than for patients treated according to other treatment protocols (5-year EFS: 31.1% and 16.4%, respectively), but difference between these groups was not significant. Between 2001 and 2007 data reporting increased to 81% from 19% noted earlier. Unfortunately, results of treatment for children over 1 year of age remain still unsatisfactory. That is why there is a need of improvement of modern, unified treatment realization as well as better data reporting. For realization of these aims adequate financial support is essential.

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New method for quantitative analysis of GD2 ganglioside in plasma of neuroblastoma patients.

Acta Biochimica Polonica (2009)

Dominik Czaplicki Irena Horwacik Aleksandra Kowalczyk Aleksandra Wieczorek Katarzyna Bolek-Marzec

Neuroblastoma, the most common extracranial solid tumour of childhood, is a malignancy of unknown origin and non-specific symptoms. One of the markers of the disease is GD2 ganglioside (disialoganglioside), which is abundantly expressed on the surface of neuroblastoma cells. Gangliosides are known to be shed by tumour cells and this phenomenon can be significant in cancer progression as they inhibit a number of immune responses both in vitro and in vivo. In search for novel markers useful in monitoring and prognosis of neuroblastoma, we developed and validated a new quantitative method of GD2 ganglioside analysis in human blood plasma. We evaluated the level of gangliosides in blood serum of 34 neuroblastoma patients using high-performance liquid chromatography. The technique was used to detect fluorescently labelled oligosaccharides derived from serum glycosphingolipids by enzymatic digestion with ceramide glycanase. The developed method allowed determination of GD2 concentrations at the picomole level and required only 40 microl of plasma, which should be particularly useful when the quantity of clinical material is limiting. Moreover, this method can be applied to study concentration of other gangliosides, as shown for GD3 ganglioside. Analysis of plasma samples from the 34 neuroblastoma patients did not reveal any correlations between the concentration of GD2 ganglioside and clinical parameters, including the results of therapy; it showed, however, that the concentration of GD2 ganglioside in the plasma of neuroblastoma patients decreased substantially in the course of treatment.

Ganglioside

10.18388/abp.2009_2476

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OP21.05: Outcome of pregnancies with prenatally diagnosed hypoplastic left heart syndrome (HLHS) in a referral center for fetal cardiology during last 12 years

Ultrasound in Obstetrics and Gynecology (2009)

Aleksandra Wieczorek Maria Respondek‐Liberska

Hypoplastic left heart syndrome (HLHS) is one of the hardest tasks of prenatal cardiology and pediatric cardio-surgery. The aim of this study was to evaluate the outcome of fetuses with prenatally diagnosed hypoplastic left heart syndrome in the referral center between 1997 and 2008. This was a retrospective analysis of 88 fetuses with HLHS referred to a tertiary center for prenatal echocardiography in mean 32 (19–40) week of gestation. 6 fetuses without postnatal confirmation of the diagnosis were excluded from the analysis. Additional extracardiac anomalies were found in 20 (23%) fetuses (Figure 1). These were: multiple malformations, acardiac twin, renal agenesis, hydronephrosis, ventriculomegaly, hypospodias, IUGR, oligo- and polyhydramnion, and symptoms of infection. One woman decided to terminate the pregnancy, 7 (8%) fetuses died in utero. 80 (91%) newborns were born alive. Out of them 23/80 (29%) were disqualified from the heart surgery. 57/80 (71%) neonates underwent the Ist stage of Norwood procedure in mean 12 (3–50) day of life. The mean time of hospitalization was 34 (1–156) days. Out of 55 operated patients, 20 (23%) died in the postoperative period. Survival of the Ist stage of Norwood procedure was 65%. In the fetuses with prenatally diagnosed HLHS in our center the overall survival rate was 42%. Although the results of the heart surgery are good, mortality and morbidity of the patients with HLHS remain one of the highest in all congenital heart diseases, in our study it was 65%. Extracardiac anomalies have significant impact on the fetal outcome and in our group they complicated 20 (23%) prenatally diagnosed HLHS.

Norwood procedure

Single Center

Fetal echocardiography

10.1002/uog.6859

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P14.04: Perinatal outcome in monochorionic versus dichorionic twin pregnancies

Ultrasound in Obstetrics and Gynecology (2012)

Aleksandra Wieczorek G Krasomski

The objective of this study was to determine the impact of chorionicity in twin pregnancy on perinatal outcome. A retrospective study of 209 twin deliveries in a tertiary center between 2003 and 2009 was conducted. We were able to determine the chorionicity of pregnancies in 148 cases and we established two groups: monochorionic (n = 56; 38%) and dichorionic gestations (n = 92; 62%). More women in dichorionic pregnancies were primigravid. All twins after ART were dichorionic. Monochorionic twins were more often delivered by cesarean section than dichorionic (93% vs. 84%; NS). Non-vertex presentation of any twin and a history of cesarean section in previous pregnancy was more common in monochorionic gestations. Monochorionic twins were at significantly higher risk for prematurity (P = 0.01), low and very low birth weight (P = 0.012), Apgar scores of 1–4 (P = 0.029) but PPROM was less common in monochorionic pregnancies relative to dichorionic (P < 0.01). We found no relation between chorionicity and cervical incompetence, hypertensive disorders, diabetes or cholestasis. 10/56 (18%) of monochorionic pregnancies were complicated by TTTS with 30% mortality. Monochorionic twins were at a higher risk for congenital malformations (19% vs. 10%; P < 0.001) and CHD (12.5% vs. 3%; P < 0.001). There was no statisticaly significant difference in the perinatal mortality between mono- and dichorionic twins (7.1% vs. 4.33%). Exclusion of TTTS cases did not affect the results. Monochorionic twin gestations were at a higher risk of perinatal complications and prematurity than dichorionic pregnancies, even after exclusion of TTTS.

Monochorionic twins

Twin Pregnancy

10.1002/uog.11954

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Bed bug bites mimicking bullous pemphigoid: a report of two cases

Dermatology Review (2016)

Aleksandra Wieczorek Jacek C. Szepietowski Katarzyna Łoza Andrzej Bizoń Julia Lanckorońska

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Wieczorek A, Szepietowski J, Łoza K, et al. Bed bug bites mimicking bullous pemphigoid: a report of two cases. Dermatology Review/Przegląd Dermatologiczny. 2016;103(4):281-284. doi:10.5114/dr.2016.61775. APA Wieczorek, A., Szepietowski, J., Łoza, K., Bizoń, A., Lanckorońska, J., & Rutkowska, K. et al. (2016). Bed bug bites mimicking bullous pemphigoid: a report of two cases. Dermatology Review/Przegląd Dermatologiczny, 103(4), 281-284. https://doi.org/10.5114/dr.2016.61775 Chicago Wieczorek, Aleksandra, Jacek Szepietowski, Katarzyna Łoza, Andrzej Bizoń, Julia Lanckorońska, Karolina Rutkowska, and Katarzyna Głogowska. 2016. "Bed bug bites mimicking bullous pemphigoid: a report of two cases". Dermatology Review/Przegląd Dermatologiczny 103 (4): 281-284. doi:10.5114/dr.2016.61775. Harvard Wieczorek, A., Szepietowski, J., Łoza, K., Bizoń, A., Lanckorońska, J., Rutkowska, K., and Głogowska, K. (2016). Bed bug bites mimicking bullous pemphigoid: a report of two cases. Dermatology Review/Przegląd Dermatologiczny, 103(4), pp.281-284. https://doi.org/10.5114/dr.2016.61775 MLA Wieczorek, Aleksandra et al. "Bed bug bites mimicking bullous pemphigoid: a report of two cases." Dermatology Review/Przegląd Dermatologiczny, vol. 103, no. 4, 2016, pp. 281-284. doi:10.5114/dr.2016.61775. Vancouver Wieczorek A, Szepietowski J, Łoza K, Bizoń A, Lanckorońska J, Rutkowska K et al. Bed bug bites mimicking bullous pemphigoid: a report of two cases. Dermatology Review/Przegląd Dermatologiczny. 2016;103(4):281-284. doi:10.5114/dr.2016.61775.

10.5114/dr.2016.61775

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Survival Benefit of Myeloablative Therapy with Autologous Stem Cell Transplantation in High-Risk Neuroblastoma: A Systematic Literature Review

Targeted Oncology (2024)

Urszula Żebrowska Walentyna Balwierz Jarosław Wechowski Aleksandra Wieczorek

Multimodal treatment of newly diagnosed high-risk neuroblastoma (HRNB) includes induction chemotherapy, consolidation with myeloablative therapy (MAT) and autologous stem cell transplantation (ASCT), followed by anti-disialoganglioside 2 (GD2) immunotherapy, as recommended by the Children's Oncology Group (COG) and the Society of Paediatric Oncology European Neuroblastoma (SIOPEN). Some centres proposed an alternative approach with induction chemotherapy followed by anti-GD2 immunotherapy, without MAT+ASCT.

Autologous stem-cell transplantation

Regimen

10.1007/s11523-024-01033-4

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[Occurrence and prognostic impact of selected factors in neuroblastoma in children].

PubMed (2010)

Aleksandra Wieczorek Walentyna Balwierz

Neuroblastoma (NBL) accounts for 6-10% of neoplastic diseases of childhood. The clinical course of NBL is very variable and depends on the presence of prognostic factors. The aim of the study is retrospective evaluation of occurrence of known prognostic factors and disease markers in patients treated in 1991-2005 in our institution. Sixty of 100 treated patients were included to the study, in whom tumor embedded in paraffin was available. In all patients, who had no genetic evaluation at diagnosis, especially MYCN amplification, FISH study was performed. In analyzed group, 29 patients died, 23 of them from NBL. Disease progression (n = 12) or relapse (n = 19) was observed in 31 patients. In the whole analyzed group, age had statistically significant influence on deaths caused by NBL (p = 0.01) and therapy failures (p = 0.00008). The statistically significant increase of NBL death incidence (p = 0.00001) and therapy failures (p = 0.00004) was found in stage 4 patients in comparison with other stages. Presence of MYCN amplification statistically significant decreases overall survival (OS) (p = 0.01) and disease free survival (DFS) (p = 0.047) for the whole analyzed group. However, presence of MYCN amplification had no statistically significant influence on OS and DFS in patients over 1 year of age. Multiple Cox analysis showed independent statistically significant influence of stage and MYCN amplification on prognosis. Employment of new treatment modalities, with treatment intensity adjusted to the risk group, but also with the specificity adapted to tumor characteristics (cytogenetic and molecular) as well as further development of supportive therapy improvement may lead to improvement of treatment results, especially in high risk group and to reduction of therapy complications and improvement of quality of life in all children with this tumor.

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Central nervous system relapse in high-risk stage 4 neuroblastoma: The HR-NBL1/SIOPEN trial experience

European Journal of Cancer (2020)

Pablo Berlanga Claudia Pasqualini Ulrike Pötschger Cinta Sangüesa Maria Rita Castellani

There is rising concern on the impact of new strategies, such as high-dose chemotherapy (HDC) and immunotherapy, on the pattern of relapse in high-risk neuroblastoma (HR-NBL). Our aim is to evaluate the incidence and identify risk factors for first recurrence in the central nervous system (CNS) in HR-NBL.Data from patients with stage 4V HR-NBL included from February 2002 to June 2015 in the prospective HR-NBL trial of the European International Society of Pediatric Oncology Neuroblastoma Group were analysed. Characteristics at diagnosis, treatment and the pattern of first relapse were studied. CNS imaging at relapse was centrally reviewed.The 1977 included patients had a median age of 3 years (1 day-20 years); 1163 were boys. Among the 1161 first relapses, 53 were in the CNS, with an overall incidence of 2.7%, representing 6.2% of all metastatic relapses. One- and three-year post-relapse overall survival was 25 ± 6% and 8 ± 4%, respectively. Higher risk of CNS recurrence was associated with female sex (hazard ratio [HR] = 2.0 [95% confidence interval {CI}: 1.1-3.5]; P = 0.016), MYCN-amplification (HR = 2.4 [95% CI: 1.2-4.4]; P = 0.008), liver (HR = 2.5 [95% CI: 1.2-5.1]; P = 0.01) or >1 metastatic compartment involvement (HR = 7.1 [95% CI: 1.0-48.4]; P = 0.047) at diagnosis. Neither HDC nor immunotherapy was associated with higher risk of CNS recurrence. Stable incidence of CNS relapse was reported over time.The risk of CNS recurrence is linked to both patient and disease characteristics, with neither impact of HDC nor immunotherapy. These findings support the current treatment strategy and do not justify a CNS prophylactic treatment.

10.1016/j.ejca.2020.10.020

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