In this study, we provide a molecular signature of highly enriched CD34 þ cells from bone marrow of untreated patients with chronic myelogenous leukemia (CML) in chronic phase in comparison with normal CD34 þ cells using microarrays covering 8746 genes. Expression data reflected several BCR-ABL-induced effects in primary CML progenitors, such as transcriptional activation of the classical mitogen-activated protein kinase pathway and the phosphoinositide-3 kinase/AKT pathway as well as downregulation of the proapoptotic gene IRF8. Moreover, novel transcriptional changes in comparison with normal CD34 þ cells were identified. These include upregulation of genes involved in the transforming growth factorb pathway, fetal hemoglobin genes, leptin receptor, sorcin, tissue inhibitor of metalloproteinase 1, the neuroepithelial cell transforming gene 1 and downregulation of selenoprotein P. Additionally, genes associated with early hematopoietic stem cells (HSC) and leukemogenesis such as HoxA9 and MEIS1 were transcriptionally activated. Differential expression of differentiation-associated genes suggested an altered composition of the CD34 þ cell population in CML. This was confirmed by subset analyses of chronic phase CML CD34 þ cells showing an increase of the proportion of megakaryocyteerythroid progenitors, whereas the proportion of HSC and granulocyte-macrophage progenitors was decreased in CML. In conclusion, our results give novel insights into the biology of CML and could provide the basis for identification of new therapeutic targets.

Coronary artery lesions are frequently detected on the initial echocardiogram of children with Kawasaki syndrome. If future studies show ectasia to have a relatively high degree of specificity for Kawasaki syndrome, the initial echocardiography may be a useful adjunctive diagnostic test.

Although adults with coronavirus disease 2019 (COVID-19) who require admission to the hospital have often required critical care, infants and children with COVID-19 have generally demonstrated milder disease severity, fewer complications, and overall a much lower case fatality rate (1-2). Neurologic manifestations have been reported with COVID-19 in adult patients including acute cerebrovascular disease, ischemic and hemorrhagic strokes, skeletal muscle injury and rare cases of encephalopathy (3-5). We report here an adolescent patient with acute encephalitis associated with COVID-19.

To detect Streptococcus pneumoniae colonization, the nasopharynx is sampled using a swab placed in skim milk-tryptone-glucose-glycerol (STGG) transport medium, and then the swab specimen or STGG medium is cultured or subjected to PCR. We evaluated the effect of swab composition and compared the sensitivities of detection of culture and PCR using swabs and swab-containing medium. Calcium alginate, Dacron polyester, or rayon-tipped swabs were inoculated with pneumococci or were immersed in nasal wash specimens from children and then placed in STGG medium. Swabs and medium inoculated with pneumococci were cultured. Swabs grew significantly more colonies than medium. The number of colonies cultured from rayon swabs or medium was significantly higher than the number cultured from the calcium alginate swab or medium. The number of colonies from both the Dacron polyester swabs and medium were significantly lower than with either calcium alginate or rayon swabs. When DNA was separately extracted from the calcium alginate swab and medium and subjected to PCR for pneumococcal detection from either S. pneumoniae-inoculated swabs or clinical specimens that grew S. pneumoniae, the sensitivity was at least 10 times higher using the swab. With Dacron polyester or rayon-tipped swabs, there was no consistent difference between the sensitivity of PCR using swabs and that of PCR using medium. Thus, calcium alginate swabs may be superior to STGG medium for the culture and PCR-based detection of S. pneumoniae. For culture, rayon swabs are superior and Dacron polyester swabs are inferior. The sensitivity of the swab and swab-containing medium for culture or PCR detection of S. pneumoniae varies with swab composition.Streptococcus pneumoniae (pneumococcus) is an important pathogen of children and adults (15). Pneumococci frequently and asymptomatically colonize the nasopharynges of infants and young children. Colonizing bacteria are the source of respiratory tract infections such as pneumonia and acute otitis media as well as invasive pneumococcal infections and serve as the reservoir for person-to-person transmission. In 2000, a heptavalent pneumococcal conjugate vaccine (PCV7) was licensed in the United States and recommended for routine administration to all infants (4). Use of this vaccine has resulted in a large decrease in the incidence of invasive pneumococcal infections in young children and a decrease in the prevalence of colonization with vaccine serotypes. The latter fact has resulted in a decrease in invasive disease in adults (21) and in infants too young to have been directly protected by vaccination (13) via herd type immunity. This has been accompanied by an apparent increase in the prevalence of colonization with nonvaccine serotypes (7,10,12). Some of these nonvaccine serotypes may have been present prior to the use of PCV7 but were unrecognized due to limitations in the sensitivity of culture and the difficulty in detecting more than one serotype in a nasopharyngeal specimen. Thus, there is a need for sensitive test...

This is a case of an 11-year-old female who was admitted with respiratory failure, requiring intubation while testing positive for SARS-CoV-2. During her recovery, she had new onset fevers and uptrending inflammatory markers. After an evaluation of infectious causes, the diagnosis of MIS-C was made approximately 1 month after her initial symptoms.

This is a retrospective chart review of 20 patients treated with a consensus driven treatment algorithm in MIS-C patients across a wide clinical spectrum. Their treatments and clinical status are described, as well as their favorable return to functional baseline by 30 days post presentation.

Aerococcus urinae has been found to cause urinary tract infection in elderly patients and has been reported as a rare cause of infective endocarditis associated with significant morbidity and death in adults. However, information regarding its occurrence in children is lacking. We report here the case of a pediatric patient with subacute A urinae infective endocarditis with mycotic aneurysms.

Background The SARS‐CoV‐2 pandemic brought challenges to all areas of medicine. In pediatric bone marrow transplant (BMT), one of the biggest challenges was determining how and when to transplant patients infected with SARS‐CoV‐2 while mitigating the risks of COVID‐related complications. Methods Our joint adult and pediatric BMT program developed protocols for performing BMT during the pandemic, including guidelines for screening and isolation. For patients who tested positive for SARS‐CoV‐2, the general recommendation was to delay BMT for at least 14 days from the start of infection and until symptoms improved and the patient twice tested negative by polymerase chain reaction (PCR). However, delaying BMT in patients with malignancy increases the risk of relapse. Results We opted to transplant two SARS‐CoV‐2 persistently PCR positive patients with leukemia at high risk of relapse. One patient passed away early post‐BMT of a transplant‐related complication. The other patient is currently in remission and doing well. Conclusion These cases demonstrate that when the risk associated with delaying BMT is high, it may be reasonable to proceed to transplant in pediatric leukemia patients infected with SARS‐CoV‐2.