Immune reconstitution was studied prospectively in 86 children who underwent allogeneic haematopoietic stem cell transplantation (HSCT). We analysed the risk of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) reactivation in correlation with the kinetics of immune recovery and in relation to other potential risk factors that may influence the reactivation of these viruses including: diagnosis, type of HSCT, source of stem cells, type of conditioning, or the occurrence of graft-versus-host disease (GvHD). The absolute number of lymphocyte subpopulations in peripheral blood was evaluated in seven timepoints following HSCT. Significantly lower values of both CD3+ and CD3+CD8+ lymphocytes on day +14 and significantly higher values of both these subsets on day +168 post-transplant in patients with CMV reactivation were observed. Significantly lower values of CD3+CD4+ subpopulation were noted in patients with CMV reactivation on day +28 post allo-HSCT. Significantly lower lymphocyte values in the group with EBV reactivation comparing with the group without EBV reactivation were confirmed only in the case of pan-B lymphocytes (CD19+) subpopulation on day +21, +28, and +84 post allo-HSCT. We identified the impact of CMV reactivation on occurrence of the intestinal acute GvHD, which occurred more frequently in the group with CMV reactivation compared with patients without reactivation. Higher incidence of chronic GvHD was also observed in patients with CMV reactivation compared to the group without reactivation. EBV reactivation occurred more frequently in patients receiving transplants from matched unrelated donors, in particular after peripheral blood stem cell transplantation and while implementing antithymocyte globulin as GvHD prophylaxis.

Background. Magnus gluteal muscle (musculus gluteus maximus) belongs to the group of lower limb girdle muscles. It is one of the biggest muscles in human organism and is located mostly superficially in gluteal region. Literature provides discussion concerning its role in movement such as walking, running and climbing as well as plastic surgery in reconstructive operations of trochanter. Magnus gluteal muscle plays an important role in orthopaedic surgery. Objectives. The goal of the study was to analyse the human magnus gluteal muscle in the foetal period. Material and Methods. The analysis was carried out on 154 muscles originating from human foetuses (including 30 females-39%) belonging to the collection of Normal Anatomy Dept. of Wroclaw Medical University. The body length was assessed with the use of vertex-tuberal (v-tub) length and it was included in the range 107-205 mm, which corresponds with the period 17-30 weeks of foetal life. The survey incorporated the following methods: anthropological, preparational and image acquisition which was acquired with the use of high-resolution digital camera. In order to take computer measurements, the following systems were exploited: Image J and Scion for Windows. Statistical analysis was carried out with the use of STATISTICA package v. 9 (t-Student test). Results. The magnus gluteal muscle was analysed in respect to sexual dimorphism and symmetry. On the basis of elicited parameters, the model of muscle increase in foetal period was defined. The following measurements were taken: v-tub, vertex-plantare (v-pl), body mass, muscle particular sides lengths and distance between corresponding measurement points. In every muscle, the lengths of four sections forming the circumference as well as the area were measured. Conclusions. No difference was observed in foetal magnus gluteal muscle sexual dimorphism or symmetry (p > 0.05). The correlation diagram was used to calculate the muscle weekly increase in foetal period. The results suggest that lesions and pathologies in the region of magnus gluteal muscle are acquired in post foetal period (Adv Clin Exp Med 2014, 23, 1, 9-16).

Background. Wilms' tumor is the most common kidney cancer in children. Treatment consists of pre-and post-operative chemotherapy, surgery and in some cases radiotherapy. The treatment of nephroblastomas is very effective. Hence, the population of adult patients cured of this cancer in their childhood is steadily growing, generating a need for longterm health assessment, including renal function, due to the specifications of the therapy and the location of the tumor. Objectives. The aim of the study was to evaluate nephrological complications after treatment for nephroblastoma. Material and Methods. The study group consisted of 50 children treated in the Department of Pediatric Hematology, Oncology and Bone Marrow Transplantation at Wroclaw Medical University (Poland) from 2002 to 2012. An analysis of the patients' medical histories was carried out. The glomerular filtration rate estimated by the Schwartz formula (GFR by Schwartz), serum creatinine levels, urea and electrolyte concentrations; the results of urinalysis and blood pressure were assessed. Each of these analyses was performed at the time of diagnosis, at the end of therapy, as well as 6 months, one year and two years after its completion. Results. The study showed that, in most cases, implemented therapy had no significant impact on the deterioration of renal parameters in the two-year period following treatment for Wilms' tumor. However, the group of patients treated with cyclophosphamide and carboplatin required more careful monitoring, due to a higher risk of renal function deterioration. Conclusions. The study shows that the problem of nephrotoxicity after treatment for Wilms' tumor is more frequent than indicated in other studies; however, the deterioration of kidney function in most cases is not serious. Additional attention should be paid to patients treated with cyclophosphamide and carboplatin. Assessment of the early and late effects of the treatment is a key element in improving the quality of the patients' life (Adv Clin Exp Med 2015, 24, 3, 497-504).

Background. Chronic myeloid leukemia (CML) constitutes only 2-3% of all leukemias in pediatric patients. Philapelphia chromosome and BCR-ABL fusion are genetic hallmarks of CML, and their presence is crucial for targeted molecular therapy with tyrosine kinase inhibitors (TKIs), which replaced hematopoietic stem cell transplantation (HSCT) as a standard first-line therapy. The disease in pediatric population is rare, and despite molecular and clinical similarities to CML in adults, different approach is needed, due to the long lifetime expectancy and distinct developmental characteristics of affected children.Objectives. The objective of this study is to evaluate treatment with imatinib in Polish pediatric patients with CML. Material and methods.We analyzed the results of treatment with imatinib in 57 pediatric patients (June 2006 -January 2016) from 14 Polish pediatric hematology and oncology centers.Results. In the study group, 40 patients continued imatinib (median follow-up: 23.4 months), while in 17 the treatment was terminated (median follow-up: 15. 1 months) due to therapy failure. In the latter group, 13 patients underwent HSCT, while 4 switched to second-generation TKIs. The 5-year overall survival rate (OS) in the study group was 96%, and the 5-year event-free survival (EFS) was 81%. Conclusions.Our results confirm that the introduction of TKI therapy has revolutionized the treatment of CML in the pediatric population by replacing the previous method of treatment with HSCT and allowing a high percentage of OS and EFS.