Across all cancers the most spectacular gains in outcomes over the last few decades have been in the field of childhood cancers. An increase to almost 80% cure rate across all the childhood cancers from about 20% a few decades ago is indeed a laudable achievement. The most contributing factor for this significant success is the integration of care and research in paediatric oncology. To support this view we present the second issue of the “Progress in Medicine” that has been entirely devoted to pediatric oncology and hematology during last few months. Present issue contains 9 original papers, 3 case presentations and 3 review papers.

Dr K. Drabko et al. presented a retrospective analysis of treatment failure in 119 children and adolescence with Ewing sarcoma treated in Polish oncology centers. Most of the treatment failures in children with Ewing’s sarcoma (92%) were caused by the underlying disease. According to presented analysis the results of treatment in childhood Ewing sarcoma are still unsatisfactory. Megachemotherapy in patients with high risk factors did not increase the number of deaths due to toxicity and contributed to reducing the number of relapses in these patients.

The value of positron emission tomography (PET) imaging based on the use of O-(2-18F-Fluoroethyl)-L-Tyrosine (18F-FET) radiotracer in 22 patients with brain tumors was discussed by authors from Bydgoszcz centre. Increased FET uptake representative for malignant brain tumor was observed in 86% of patients. No FET uptake was observed in three patients. Based on the kinetic analysis of FET uptake we assessed the malignancy degree of suspected tumors finding compliance in 5 of 6 children with confirmed histological diagnosis of gliomas (compliance of 100% in low grade gliomas, 66.7% in high grade gliomas). These preliminary results indicate that FET-PET is a potentially effective method to identify malignant brain lesions, to monitor the disease course and predict the malignancy degree of lesions with unknown histology, based on kinetic analysis of FET uptake.

The other article from the same centre presents assessment of flow cytometry minimal residual disease (MRD) in children with acute lymphoblastic leukemia (ALL) in local laboratory and its validation in a reference laboratory. MRD values obtained locally showed strong correlations with the results from reference laboratory at days 15 and 33 (p < 0.01). It was confirmed that MRD values determined in Bydgoszcz were comparable with results in the reference laboratory.

L-asparaginase (L-ASPA) is one of the basic drug in the treatment of the acute lymphoblastic leukemia (ALL) in children. Dr M. Czogała et al. from Cracow analyzed the influence of decrease of L-ASPA activity and allergic reaction on the treatment outcome in children with ALL. Eighty seven patients treated with ALL IC-BFM 2002 Protocol were enrolled to the study. Activity below therapeutic values was noticed in 21% patients and allergic reaction occurred in 49% patients. Disease free survival (DFS) did not differ significantly between the groups with therapeutic and low L-ASPA activity. The authors concluded that decrease in L-ASPA activity in children treated for ALL was not associated with outcome deterioration but was significant risk factor of hypersensitivity to this drug.