Background:In children, the complications of severe acute respiratory syndrome coronavirus 2 infection occur less frequently than in adults but the characteristics of this disease in oncology patients are not well characterized. Methods: This was a retrospective study in patients younger than 18 years of age with coronavirus disease 2019 (COVID-19) and cancer diagnoses between April and September 2020. Demographic variables, laboratory, and radiologic findings and complications of each case were identified. A descriptive analysis was performed. Results: A total of 33 patients were identified; the median age was 10 years. Fifteen patients (42%) were in chemotherapy at the time of the infection diagnosis, in two patients the chemotherapy protocol was permanently suspended. The most common symptom was fever in 20 patients (60%). Seven patients (21.2%) showed mild pneumonia, four patients (12.1%) severe pneumonia, and three cases (9.0%) were classified as critical. In the evaluated cohort, five patients (15.1%) died, and in two of those, death was caused by COVID-19 infection. Conclusions: Children with an oncologic disease, the search for COVID cases should be oriented to patients with fever, including febrile neutropenia, the presence of respiratory symptoms, and the search for epidemiologic contact. A higher frequency of complications and mortality attributed to COVID-19, two in pediatric oncohematologic patients was found. Institutional strategies to detect the infection early and lower institutional infection are indicated.

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<p><strong>Introducción.</strong> El trasplante de precursores hematopoyéticos es una alternativa en el tratamiento de diversas condiciones en la población pediátrica. La intensidad del acondicionamiento para el trasplante predispone al desarrollo de complicaciones en los receptores. Las infecciones por el virus herpes simple 1 (HSV-1), el virus herpes simple 2 (HSV-2), el citomegalovirus (CMV) humano y el virus de Epstein-Barr (EBV) son una causa importante de morbimortalidad en estos pacientes. La reactivación de infecciones latentes puede producir descargas virales asintomáticas detectables en la saliva, lo cual ayuda a determinar el comportamiento de dichas infecciones en pacientes con trasplante y a establecer el diagnóstico temprano de la reactivación.<br /><strong>Objetivo.</strong> Evaluar el comportamiento de la descarga viral de HSV-1, HSV-2, CMV y EBV en la saliva de pacientes hospitalizados en la Unidad de Trasplante de la Fundación HOMI - Hospital de la Misericordia, entre enero y noviembre de 2012.<br /><strong>Materiales y métodos.</strong> Se evaluaron muestras de saliva de 17 receptores de trasplante. La presencia de ADN de HSV-1, HSV-2, CMV y EBV en las muestras de saliva se detectó mediante reacción en cadena de la polimerasa convencional.<br /><strong>Resultados.</strong> Se detectó el ADN del HSV-2 en la saliva de cuatro pacientes, del CMV en la de cuatro y del EBV en la de nueve, lo cual se asoció con leucopenia. Cuatro de los 17 pacientes presentaron cargas simultáneas de CMV y EBV. No se detectó el ADN del HSV-1.<br /><strong>Conclusiones:</strong> Se demostró una descarga asintomática de HSV-2, CMV y EBV asociada a leucopenia en la saliva de los pacientes.</p>

Background: Iron overload has been implicated as a key co-morbid factor in post-stem cell transplant (SCT) outcomes. Quantifying iron burden has been a challenge as serum iron markers are imprecise. MRI is a relatively new and non-invasive tool that more accurately measures iron burden. We conducted a prospective study using MRI to assess iron burden in children undergoing SCT. Objective: To determine the prevalence of iron overload using R2 MRI of the liver in a pediatric allo SCT population both pre and post-SCT. Relationships between excess iron and adverse outcomes such as graft vs. host disease (GVHD), infection, and death were secondary objectives. Methods: Children $5 years old undergoing an allo SCT at Children's Hospital Boston from 2007-2009 were eligible for this study. Iron overload was defined as a liver iron concentration $ 1.5 mg iron/g dry liver tissue. A paired t-test was conducted with a 5 0.05 to compare iron load at the two specified time points. A two-sample two-sided t-test was conducted at each time point for association with risk factors described above with a 5 0.1. This study was IRB approved. Results: Twenty-eight patients were enrolled. The most common diagnoses were Pre-B ALL (N 5 7), AML (N 5 6), and aplastic anemia (N 5 5). Pre-SCT, 82% (95% CI: 66%-98%) of patients had iron overload by R2 MRI. At day 100 post-SCT, 95% (95% CI: 65%-100%) had iron overload. The mean iron concentration (6 std error) was 4.97 6 3.54 mg/g dwt liver at pre-SCT and 7.55 6 4.37 mg/ g dwt liver at day 100 post-SCT. The day 100 post-SCT mean value was significantly higher than the mean value at pre-SCT (2.15 mg/g dwt liver, p\0.0001). For patients who developed an infection during the post-SCT period, the mean iron concentration, compared to patients who did not develop an infection, was significantly higher at pre-SCT and at day 100 post-SCT (p 5 0.029 and p 5 0.0055, respectively). There was no statistically significant difference in iron concentration between patients who developed GVHD or died and those who did not. Conclusions: We found that a high proportion of pediatric allo SCT patients have iron overload pre-SCT. In addition, there is a statistically significant rise in iron post-SCT (p\0.0001) and an association with increased incidence of infection in patients with elevated iron. Larger multi-center studies should be conducted to further examine the consequences of iron overload and evaluate potential interventions in this patient population.

elevation of ALC (day 16) along with decrease in chimerism to 85%. This time alemtuzumab was used promptly, leading to successful outcome (Table 1). Conclusion: In patients with Fanconi Anemia undergoing transplant, the development of mixed chimerism may be due to incomplete lympho-depletion and return of recipient lymphocytes. In these cases, prompt and aggressive lymphoid depleting therapy is warranted to prevent graft rejection.