bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serial assessment of humoral immunity in pediatric AML: A prospective study.
Authors: Bakhshi Sameer , Bansal Anuj Kumar , Sharawat Surender Kumar , Gupta Ritu , Sreenivas Vishnu kumar 
Published: March 2020

9551 Background: Humoral immunity has been evaluated in pediatric ALL; data in pediatric AML is lacking. The objectives of this study were to assess humoral immunity on follow-up in pediatric AML patients. Methods: From April 2010-May 2011, 45 consecutive AML patients 1-18 years old were prospectively enrolled with 7 healthy controls. Immunoglobulin (Ig) levels in 45 patients and B-lymphocytes (CD19+) in 29 patients were assessed at diagnosis, post-induction, post-consolidation, 3 and 6 months follow-up and relapse. Results: At diagnosis, Ig levels were higher in patients as compared to healthy controls (IgG, p=0.041; IgA, p=0.07; IgM, p=0.16) while B-cells were lower (p=0.001). Patients with gum hypertrophy had low Ig levels (IgG, p=0.007; IgA, p=0.003; IgM, p=0.06). CR rate was 84.4% (38/45); EFS 40% and OS 58% at 20 months follow-up. Post-induction, there was reduction in IgM (p<0.001) and IgA (p=0.048) levels and increase in B cells (p<0.001). Using generalized estimating equation regression model, average reduction from post-induction till 3 month follow-up was 36.9 units/visit (IgG); 10.3 units/visit (IgA); 0.32 units/visit (IgM) in those with continuous CR (group-1, n=24) and 91 units/visit (IgG); 8.9 units/visit (IgA); 1.5 units/visit (IgM) in those who relapsed (group-2, n=14). Difference between these two groups was significant for IgA (p=0.017). There was increase in IgG (p=0.52) and IgA levels (0.21) at relapse when compared with post-consolidation values. B-cells had an average increase of 3.6 units/visit (p=0.012) in group 1 and decrease of 0.58 units/visit (p=0.82) in group 2; (group-1 vs group-2, p=0.10). There was no significant correlation of baseline Ig and B cells with CR rate, EFS and OS. Conclusions: This is the first study to evaluate humoral immunity serially in pediatric AML. AML patients with gum hypertrophy have low IgG and IgA at diagnosis. On serial monitoring, B cells show an increase in patients who are in continuous CR while those who relapse tend to show a reduction on follow-up. Further, on follow-up, although all Ig decrease, but the reduction in IgA is significantly lower in patients who relapse suggesting their possible role in disease biology.
Treatment outcomes of pediatric oncology patients in Zambia.
Authors: Slone Jeremy , Chunda-Liyoka Catherine , Perez Marta , Mutalima Nora , Newton Robert , Chintu Chifumbe , Kankasa Chipepo , Chipeta James , Heimburger Douglas C. , Vermund Sten H. , Friedman Debra L. 
Published: March 2020

9558 Background: Due to challenges in the delivery of pediatric oncology care in low-middle income countries (LMIC), diagnosis and treatment remains inadequate for the majority of patients. The University of Zambia School of Medicine/University Teaching Hospital (UTH) and Vanderbilt University School of Medicine/Vanderbilt Institute for Global Health established a partnership to investigate treatment outcomes at UTH, the only institution providing pediatric oncology care in Zambia, and assess risk factors associated with treatment abandonment. Methods: A retrospective study was conducted in a cohort of patients, presenting from July 2008 – June 2010, using an established database and medical record review. Results: Of the 230 children enrolled in the database, 162 met the inclusion criteria. The average age at diagnosis was 6.0 years; males comprised 55.6% of the cohort; 51.6% had a histopathological diagnosis and 10.5% of the cohort was HIV positive. The most common diagnoses were lymphoma (25.9%), Wilms tumor (22.8%), and retinoblastoma (17.9%). Leukemia and Kaposi sarcoma accounted for 7.4% each. Death (46.3%) and abandonment of treatment (45.7%) were the most common outcomes with only 8.0% having completed treatment or currently undergoing treatment, including palliative regimens, at the time of data acquisition. Residence in Lusaka or Central provinces, closest in proximity to UTH, was associated with a decreased risk for abandonment of treatment (Odds Ratio (OR) 0.41 (95% CI 0.21-0.81, p = 0.009) while maternal education less than secondary school (OR 2.73 95% CI 1.2-6.6, p = 0.03) was associated with an increased risk for abandonment of treatment. Conclusions: At the only pediatric cancer center in Zambia, treatment outcomes are dire with the majority of the cohort abandoning treatment or dying during therapy. Challenges include access to cancer chemotherapy, logistical facilitation, fiscal support of radiotherapy, and community engagement. Further investigation is required to inform effective intervention strategies to improve outcomes.
Demographics, treatment, and outcome of retinoblastoma: A large series with protocol-based management.
Authors: Reddy Vijay Anand Palkonda , Honavar Santosh , Fairooz Puthiyapurayil M , Ali Mohammed Javed , Vemuganti Geeta K 
Published: March 2020

9568 Background: Retinoblastoma is the most common primary intraocular malignancy of childhood with incidence of 1 in 20,000 and the third most common pediatric cancer. In the previous decades, early diagnosis and treatment of retinoblastoma have improved survival rates in developed countries. Nevertheless, protocol based management help reduce the mortality rate associated with advanced tumors. The purpose of the study is to report demographics, management, and outcome of retinoblastoma in the Ocular oncology centre of South India. Methods: Consecutive case series of 1,543 eyes of 1,067 patients with 22 years of follow-up. Demographics, clinical features, treatment and outcome (survival, organ salvage and function salvage) were analyzed. Management comprised of focal therapy for small tumors, standard triple drug chemoreduction for larger (>4mm) tumors, high dose chemoreduction and periocular chemotherapy for vitreous seeds, and enucleation for advanced tumors. Adjuvant therapy was provided in patients with histopathologic high-risk factors for systemic metastasis. Orbital retinoblastoma was managed with a multimodal treatment protocol. Results: Sixty-six percent were <3 years of age. Forty-five percent were bilateral. Symptoms were leucocoria (33%), vision loss (10%), proptosis (6%), and squint (6%). The tumor was intraocular in 94% and orbital in 6%. Management was by protocol and included enucleation (52%), chemoreduction (26%), focal therapy (11%), and external beam radiation (5%). Fifty-five percent of enucleated patients had histopathologic risk factors for metastasis and received adjuvant chemotherapy. Chemoreduction with focal therapy resulted in eye and vision salvage in 92%. Overall, 94% survived. Conclusions: Protocol-based management of retinoblastoma provides excellent prognosis for survival, eye salvage and vision salvage.
Preclinical study of a PARP inhibitor in neuroblastoma.
Authors: Addioui Anissa , Belounis Assila , Cournoyer Sonia , Nyalendo Carine , Brito Rose- Marie , Beaunoyer Mona , Teira Pierre , Sartelet Hervé 
Published: March 2020

9570 Background: Neuroblastoma (NB) is the most common extracranial solid tumor of childhood. In spite of many therapeutic improvements, only 60% survive long term despite aggressive combinations of multi-agent chemotherapy. In previous studies, we have demonstrated that tumor initiating cells (TIC) expressing CD133 (CD133high) in NB are more resistant to chemotherapy. Moreover, these cells express higher levels of PARP-1, a central protein involved in DNA repair. PARP-1 expression is significantly lower in NB usually showing spontaneous regression than in standard NB, suggesting an implication of PARP-1 in NB progression. The objective of this study is to determine the efficacy in vitro of AG-014699 (AG), a PARP- inhibitor, used in monotherapy or in combination to cisplatine (CP) and doxorubicine (DR), classical chemotherapeutic agents used in NB treatment, on NB cell survival. Methods: Six NB cell lines (parental or CD133high purified by flow cytometry (FACS)) were treated with AG alone or in association to CP or DR. PARP-1 ELISA protein assay was used to determine the optimal drug concentration needed to inhibit the protein. Cell survival was measured by MTT test. Western Blots were done to evaluate any apoptotic or autophagic pathway modulations. Quantification of DNA damage in treated cell was done by immunofluorescence of H2A-X protein. Results: We showed that a 4µM concentration of AG is sufficient for PARP-1 inhibition. One third of celllines presented a sensitivity to AG when used in monotherapy with an IC50 lower than 5µM. However, AG demonstrated synergistic effects when associated to DR, decreasing the IC50 by half, although none is observed when combined to CP. Sentitivity of the TIC did not appear to be more important than the bulk cells. With increasing concentration of AG, our WB showed no increase in cleaved Caspase-3 suggesting no modulation of the apoptotic pathway. However, autophagy seemed to be upregulated confirmed by an increase in cleaved LC3 II protein. Double strand breaks increased 2.5 folds when 4µM AG is added to the IC50 of DR. Conclusions: AG used in combination at potentially therapeutic doses shows promising results in NB. These results will allow for the improvement of NB treatments by introducing a new therapeutic strategy.
Substitution of cisplatin for etoposide in 2 of 3 induction cycles of CAV/IE with subsequent irinotecan and vincristine for relapse in adults with Ewing sarcoma (ES) and primitive neuroectodermal tumor (PNET).
Authors: Rushing Daniel A. , Ezewuiro Obiageli , Staehler Sandra S. , Potter Kristin , Rojas Luis , Wagner Stephanie Glacy 
Published: March 2020

9571 Background: Treatment for adults with cyclophosphamide, doxorubicin and vincristine alternating with ifosfamide and etoposide (CAV/IE) for ES/PNET is based on the success reported in children however the same treatment in adults is less effective. 50% of relapsed disease is expected to occur in the lungs with median survival of 12.5 months (mo) after relapse. Since Cisplatin is used for relapse, we initially substituted cisplatin for etoposide in courses # 2 and # 3 of IE for 2 patients (pts) who were not responding to IE as determined by serial CT scanning and then used it for all pts. Relapsed pts were treated with irinotecan + vincristine (IRI-V) for at least 2 cycles as salvage therapy. We report the effect of cisplatin on influencing the relapse pattern and the effect of IRI-V on survival for pts after relapse Methods: A retrospective chart review of 19 consecutive adult pts (July 2004 to June 2011), with newly diagnosed ES /PNET were treated with CAV/IE as per H. Grier NEJM 2003 and modified as a 14 day cycle. Cisplatin 20 mg/m2 I.V. q d X4 was substituted for etoposide for courses # 2 and 3 of IE and combined with ifosfamide as above (IC) followed by surgery or RT. For pts with relapse Irinotecan was given I.V. 20mg/m2 days 1-5 & 8-12 + vcr I.V. 2mg days 1 & 8 q21 days for 2 or more cycles. Repeat treatment with CAV, IE or IC was also utilized for relapse. We evaluated the toxicities, the pattern of relapse and the survival after relapse with these treatments Results: Grade IV hematologic toxicity occurred in 11 of 19 pts treated with CAV vs. 7of 19 pts treated with IE vs. 7 of 19 pts treated with IC and 1 of 11 pts treated with IRI-V but 3 of those 11 pts had Grade IV diarrhea. Median survival was 44.8+ mo for 10 pts with non- metastatic and 23 mo for 9 pts with metastatic disease respectively. More importantly median survival from the time of relapse was 22.5+ mo, (range 12.7 to 31+ mo). 11 pts relapsed: 2 pts only in bone, 9 pts Local only, 0 pts had distant lung recurrence Conclusions: Cisplatin appears to markedly alter the relapse pattern in adults with ES/PNET and Irinotecan +vcr appears to prolong survival in relapsed pts previously treated with cisplatin.
Insurance retention in adolescent and young adult survivors of malignancies in a vertically integrated health care system.
Authors: Cooper Robert Michael 
Published: March 2020

9588 Background: Adolescents and Young Adults (AYA) with cancer are a unique population of patients. This group is afflicted with a wide range of cancer types. AYA patients often have delays in diagnosis due to issues related to insurance and continuity of care and have less participation clinical trials related to other age groups. Survivors are at risk of late effects of treatment. A vertically integrated health care system with a comprehensive electronic medical record provides an ideal opportunity to care for adolescent and young adult (AYA) cancer survivors and conduct survivorship research. In this system, patients who complete oncology care return to primary medical care but can be tracked in a systematic fashion. Methods: We evaluated the insurance retention of survivors of AYA malignancies by querying the Cancer Registry and identified 13,240 known survivors of malignancies diagnosed within the system between 1990 and 2005. We looked at the percentage of survivors who were still cared for in our system at certain time points after diagnosis. We then reanalyzed the group by ethnicity, disease, and age at diagnosis. Results: The retention rate for all patients was 88% at 1 year, 64 % at 5 years, and 52% at 10 years. The retention rates were similar regardless of ethnicity. When we looked at the influence of age at time of diagnosis we noted that the younger the patients were at diagnosis the lower the percentage of those retaining insurance at the 10 year time point. We analyzed the group by the more common cancers and noted that patients diagnosed with breast cancer had greatest retention at 10 years of 68%. Conclusions: The lengthy insurance retention of adolescent and young adult cancer survivors makes a vertically integrated medical care system an ideal population laboratory for cancer survivorship research in this understudied population of cancer survivors.
Quality of cancer family history and referral for genetic counseling and testing among oncology practices: A pilot test of quality measures as part of the ASCO Quality Oncology Practice Initiative (QOPI).
Authors: Wood Marie , Kadlubek Pamela , Lu Karen H. , Wollins Dana , Weitzel Jeffrey N. , Neuss Michael N. , Hughes Kevin S. 
Published: March 2020

CRA1505 The full, final text of this abstract will be available at abstract.asco.org at 12:01 AM (EDT) on Monday, June 4, 2012, and in the Annual Meeting Proceedings online supplement to the June 20, 2012, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Monday edition of ASCO Daily News.
Outcome in adolescent and young adult (AYA) patients compared with younger patients treated for high-risk B-precursor acute lymphoblastic leukemia (HR-ALL): A report from the Children’s Oncology Group study AALL0232.
Authors: Larsen Eric , Raetz Elizabeth A. , Winick Naomi Joan , Salzer Wanda L. , Nachman James B. , Devidas Meenakshi , Hunger Stephen , Carroll William L. 
Published: March 2020

CRA9508 The full, final text of this abstract will be available at abstract.asco.org at 12:01 AM (EDT) on Saturday, June 2, 2012, and in the Annual Meeting Proceedings online supplement to the June 20, 2012, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Saturday edition of ASCO Daily News.
New insights into the risk of breast cancer in childhood cancer survivors treated with chest radiation: A report from the Childhood Cancer Survivor Study (CCSS) and the Women's Environmental Cancer and Radiation Epidemiology(WECARE) Study.
Authors: Moskowitz Chaya S. , Chou Joanne F. , Wolden Suzanne L. , Bernstein Jonine L. , Malhotra Jyoti , Friedman Danielle Novetsky , Mubdi Nidha Z. , Henderson Tara O. , Leisenring Wendy M. , Stovall Marilyn , Hammond Sue , Boice John D. , Hudson Melissa M. , Diller Lisa , Bhatia Smita , Neglia Joseph Philip , Begg Colin B. , Robison Leslie L. , Oeffinger Kevin C. ,   WECARE Study Collaborative
Published: March 2020

CRA9513 The full, final text of this abstract will be available at abstract.asco.org at 12:01 AM (EDT) on Monday, June 4, 2012, and in the Annual Meeting Proceedings online supplement to the June 20, 2012, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Monday edition of ASCO Daily News.
Adherence to hormone treatment for breast cancer and beliefs about treatment and screening.
Authors: Lin Jenny J , Joseph Kathie-Ann P. , Fei Kezhen , Franco Rebeca , Bickell Nina 
Published: March 2020

e11004 Background: Beliefs about medications, more than knowledge, have been found to affect medication adherence. For breast cancer patients, at least 5 years of daily adjuvant hormonal therapy (HT) improves survival but it is often difficult for women to sustain therapy. Qualitative studies suggest women take HT to prevent breast cancer recurrence. We sought to assess whether beliefs about HT and screening were associated with ongoing HT adherence. Methods: Patients with a new early-stage breast cancer enrolled in an IRB-approved RCT to reduce disparities in care in New York City were telephone surveyed 6 months after their surgical treatment for breast cancer to assess knowledge, attitudes and beliefs about breast cancer, its treatment and prevention. Adherence was defined as a positive response to “are you now taking hormonal therapy (e.g., tamoxifen, arimidex)?” Beliefs about HT and mammogram screening were assessed. Bivariate analyses were conducted with t tests, chi square or Wilcoxon rank sum tests; multivariate analysis used a stepwise logistic regression. Results: Of 333 enrolled women, 233 were recommended to take HT. Of these, 187 (80%) women were prescribed HT and 172 (92%) were still adherent 6 months after surgery. Fifty-three percent of women were bothered by side effects but all were adherent; however, of the 15 women who stopped HT, 6 (40%) stopped due to side effects. Sixteen percent of women expressed difficulty paying for HT but all were adherent. Patients adherent to HT had stronger beliefs in both HT as treatment and prevention and in the importance of regular mammograms to stay healthy. A multivariate model including race, insurance, HT knowledge and beliefs found that only beliefs about HT and mammogram screening were associated with adherence (belief about HT: OR=1.1; 95%CI: 1.03-1.11; belief about mammogram: OR=1.55; 95% CI: 1.06-2.27) [model c=.84; p<0.0001]. Conclusions: Ongoing HT adherence is related to beliefs about both treatment and screening.Adherence is not related to HT knowledge, side effects, cost, insurance or patient race. Understanding patients’ beliefs about screening and treatment may help physicians enable women to adhere to long-term therapy.
Variations of the ER, PR, and HER2 expression status according to operation day in breast cancer patients.
Authors: Arik Zafer , Aksoy Sercan , Sendur Mehmet Ali Nahit , Yaman Sebnem , Altundag Kadri 
Published: March 2020

e11009 Background: Estrogen receptor (ER), progesteron receptor (PR) and HER-2 are prognostic and predictive markers in the management of breast cancer treatment. Delay in fixation of the specimens may reduce the ability to detect breast cancer biomarkers and resulting in false negative immunhistochemical results. Handling of specimens from operation rooms to pathology laboratories may delay sometimes, especially Fridays. We hypothesized that ER, PR and HER-2 expression status may change according to the day of surgical procedure. Methods: Patients who operated between 2005 and 2010 for breast cancer in our Hospital were analyzed retrospectively. Consecutive 462 patients who had breast conserving surgery and modified radical mastectomy were included into the study. Patient’s demographics data and tumor characteristics and surgical procedure day were obtained from medical charts. Results: The mean age of the study population was 50±11 years. There were not differences between the T, N, M stage and age of patients according to operation day. ER, PR, HER-2 expressions were similar in Monday, Tuesday, Wednesday and Thursday. So we grouped the patients operated on Friday and others. Among the patients, 121 (26%) were operated on Friday. ER and PR negativity was higher on Friday procedures than the other weekdays (40% vs 23.2%; p=0.008 and 35.7% vs 27.9%; p=0.08, respectively). HER-2 positivity on Friday was significantly higher than the other weekdays (41.9% versus 23.4%; P=0.005). Conclusions: Cold ischemic time is the interval between removal of the tissue and placement in the tissue fixative. ER and PR are thermolabile proteins whose levels of expression are altered by prolonged cold ischemic time. Studies have shown delays in handling of breast cancer tissues affect biomarkers positivity and some tumors were classified falsely as negative. Specimens obtained on Friday may have more delaying for handling; therefore may have more hormon receptor negative results. In our study we have shown that ER negativity and HER-2 positivity are significantly higher on patients who were operated on Friday. Our study showed that handling of the specimen to the pathology laboratories is crucial and affect the treatment decisions.
Young patients with breast cancer (< 35 years): Single-institution study of 194 patients from India.
Authors: Mohanti B. K , Raina Vinod , Gogia Ajay , Deo S. V. S , Shukla N. K 
Published: March 2020

e11013 Background: Breast cancer in young women ( < 35 years) is uncommon and accounts for 1-2 % of all breast cancer in the West .There is paucity of data on young breast cancer from India. The aim of our study was to assess clinical and pathological parameters and outcome in young breast cancer patients. Methods: Annually we register approximately 350 new cases of breast cancer of whom young patients constitute a small fraction. This analysis was carried out in 194 patients with aged 35 years or less, who were registered in our clinic between 2000-2009, this constituted about 5.5 % of all new cases. Patients records were analysed from computer database using ICD code (C-50) Results: The median age was 31 years (range 21-35). The median duration of symptoms was 11.8 months (range 0.5-40). Breast lump was the commonest (93%) presenting symptom (left >right side). Ninety percent of patients were married and median age at first child birth was 23 years. Positive family history was elicited in 8 patients, and 3 patients presented with synchronous malignancy. The TNM (7th edition) stage distribution was stage I was 3 %, stage II- 20%, stage III- 55%, and stage IV- 22%. The median clinical tumour size was 5.9 cm. Modified Radical mastectomy was the commonest surgical procedure and this was done in 81 % of cases. The histopathological analysis showed 94% had infiltrating ductal carcinoma. Sixty percent of tumours were high grade and 56% had pathological node positive disease. ER/PR status and Her2 Neu status was available in 65% and 50% respectively. Out of these patients ER and her2neu positivity was 40% and 37% respectively. Triple negative breast cancer (TNBC) constituted 31%. A combination of anthracyclines and taxanes were used in the vast majority of patients and herceptin was used only in 5 %. With a median follow up of 30 months, three years event free (EFS) and overall survival (OS) was 50% and 60%. Higher Nodal stage, tumour size (>5 c.m ), negative ER/PR status and visceral metastasis at baseline predicted poor outcome. Conclusions: Young women constituted 5.5% cases with higher proportion of triple negativity, this is higher than the western population reflecting younger age of our population of breast cancer in general with a resultant poorer outcome.