{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:29:34Z","timestamp":1760956174138,"version":"3.41.2"},"reference-count":43,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The hyper\u2010inflammatory response, also known as multisystem inflammatory syndrome in children (MIS\u2010C), represents a major concern in children with SARS\u2010CoV\u20102 infection. We report bone marrow features of three patients with MIS\u2010C who were diagnosed during the first wave of the SARS\u2010CoV\u20102 pandemic. A bone marrow evaluation was performed at onset of the inflammatory condition in order to exclude secondary hemophagocytic lymphohistiocytosis (sHLH). The bone marrows of the patients presented common features: the erythroid and megakaryocytic lineages were prominently affected and hemophagocytosis was moderately increased, differently than observed in sHLH. Megakaryocytopoiesis was increased, representing a peculiar feature of MIS\u2010C differing from sHLH. SARS\u2010CoV\u20102 RT\u2010PCR and viral panel were studied in bone marrow aspiration samples. MIS\u2010C is a rare complication of SARS\u2010CoV\u20102 infections in children. An immuno\u2010dysregulation considering both innate and adaptive immunity together with vascular inflammation and endothelial dysfunction play a major role. Our observations, although limited due to the small sample size, suggest that there are unique features in the bone marrow of patients with MIS\u2010C that are likely secondary to immuno\u2010dysregulation, and there are notable differences in bone marrow features compared to those reported in sHLH.<\/jats:p>","DOI":"10.1002\/pbc.29919","type":"journal-article","created":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T12:44:15Z","timestamp":1660999455000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Common bone marrow signature in COVID\u201019\u2010associated multisystem inflammatory syndrome in children: A first\u2010wave small case series experience"],"prefix":"10.1002","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2113-4505","authenticated-orcid":false,"given":"Maria Antonietta","family":"De Ioris","sequence":"first","affiliation":[{"name":"Department of Haematology\/Oncology, Cell and, Gene Therapy Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Scarselli","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Pediatric Emergency Department (DEA) Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9834-9619","authenticated-orcid":false,"given":"Claudia","family":"Bracaglia","sequence":"additional","affiliation":[{"name":"Division of Rheumatology and Laboratory of ImmunoRheumatology Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Perrotta","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Pediatric Academic Department Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Santilli","sequence":"additional","affiliation":[{"name":"Pediatric Academic Department Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-6914","authenticated-orcid":false,"given":"Giulia","family":"Ceglie","sequence":"additional","affiliation":[{"name":"Department of Haematology\/Oncology, Cell and, Gene Therapy Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"},{"name":"University of Tor Vergata  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3906-4410","authenticated-orcid":false,"given":"Francesco","family":"Fabozzi","sequence":"additional","affiliation":[{"name":"Department of Haematology\/Oncology, Cell and, Gene Therapy Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"},{"name":"University of Tor Vergata  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Agrati","sequence":"additional","affiliation":[{"name":"Cellular Immunology Laboratory IRCCS National Institute for Infectious Diseases \u201cL. Spallanzani\u201d  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giusi","family":"Prencipe","sequence":"additional","affiliation":[{"name":"Division of Rheumatology and Laboratory of ImmunoRheumatology Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Alaggio","sequence":"additional","affiliation":[{"name":"Department of Pathology Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Mastronuzzi","sequence":"additional","affiliation":[{"name":"Department of Haematology\/Oncology, Cell and, Gene Therapy Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"De Vito","sequence":"additional","affiliation":[{"name":"Department of Pathology Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2648"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2005073"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-020-1065-5"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2021.11.002"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-321385"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1710"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31094-1"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.10369"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.048360"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.10374"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560\u20107917.es.2020.25.22.2001010"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021756"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021680"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-021-03993-5"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.09.016"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-1054-6"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.09.034"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41590-021-01123-9"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16860"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqaa124"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020006505"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-020-0613-1"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-021-00793-y"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(20)30115-4"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38690"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/r3k9l6"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-020-02895-w"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-020-02896-9"},{"issue":"5","key":"e_1_2_10_30_1","doi-asserted-by":"crossref","first-page":"e283","DOI":"10.1111\/bjh.16934","article-title":"Secondary HLH is uncommon in severe COVID\u201019","volume":"190","author":"Wood H","year":"2020","journal-title":"Br J Haematol"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28931"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.14740\/jmc3520"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.04998.x"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-07-656157"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23982"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2010472"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199608000-00006"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/0952-7915(93)90139-J"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390\u2010022\u201002029\u20104"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI140970"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021012431"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2016.00118"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/stem.1691"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.713631"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.29919","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pbc.29919","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.29919","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T10:43:12Z","timestamp":1692700992000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.29919"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,20]]},"references-count":43,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1002\/pbc.29919"],"URL":"https:\/\/doi.org\/10.1002\/pbc.29919","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"type":"print","value":"1545-5009"},{"type":"electronic","value":"1545-5017"}],"subject":[],"published":{"date-parts":[[2022,8,20]]},"assertion":[{"value":"2022-03-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e29919"}}