bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone mineral density of pretreatment Japanese women with breast cancer; Efficacy of oral bisphosphonates with aromatase inhibitor
Authors: Yamada K. , Kohno N. , Kaise H. , Ohta D. , Ogata A. , Ueno F. 
Published: March 2020

19679 Background: From the good results of the ATAC trial and the ITA trial, standard hormonal therapy for postmenopausal breast cancer has changed from tamoxifen to aromatase inhibitor. However concerning the rate of skeletal-related events(SREs) including bone fracture, osteopenia and osteoporosis, a decrease in bone mineral density (BMD), It is reported that aromatase inhibitor cause higher than tamoxifen. According to the 2003 ASCO guidelines on the role of bisphosphonates in women with breast cancer, most women with newly diagnosed breast cancer are at risk of osteoporosis due to either their age or their breast cancer treatment. The purpose of the study is to investigate BMD of pretreatment Japanese women with breast cancer, and to investigate the efficacy of bisphosphonate for prevention from osteoporosis by aromatase inhibitor. Methods: From 2002, we have investigated BMD of 130 patients with breast cancer who underwent breast cancer operations in this hospital. BMD measurement was performed at A-P spine (L2–4) before treatment for breast cancer. The mean value of BMD for postmenopausal and premenopausal patients is compared with the value of average for Japanese women.Also we experienced 92 cases of postmenopausal breast cancer patients who were undergone breast cancer operations and take aromatase inhibitor after operations in this hospital. We selected 2 drugs. One is Anastrozole(ArimidexR) as an aromatase inhibitor, and the other is Alendronate(BonaronR) as a oral bisphosphonate drug. Results: The mean value of BMD for postmenopausal and premenopausal patients is 0.823 (vs. 0.90 for average) and 1.013 (vs. 1.03), respectively. This study shows that BMD of postmenopausal patients is trend lower than average. Tumor markers did not show significant difference. In the other study, the number of NTX which patients take Alendronate with Anastrozole decreased about 40% than which patients take Anastrozole alone. Also the rate of SRE is lower. Conclusions: The results suggest that the efficacy of bisphosphonates for prevention from SREs by aromatase inhibitor. Also BMD measurement seems significant for breast cancer patients before treatment including hormonal therapy. No significant financial relationships to disclose.
Opinions of the Turkish population on cancer and being informed for the diagnosis of cancer: An opinion survey
Authors: Yalcin B. , Yalcin S. , Buyukcelik A. , Sencan O. , Dogan M. , Turk M. , Ozdemir F. , Isikdogan A. , Er O. , Akbulut H. , Icli F. 
Published: March 2020

19680 Background: Opinions of the Turkish population on cancer, and their probable attitudes if one of their relative or themselves would have cancer diagnosis are investigated. Methods: The age, gender, profession, education levels of the subjects, their overall opinions on cancer are recorded by an opinion survey. Questions regarding if one of their first degree relatives had cancer, would they like the diagnosis being told to the patient and if they were to be the patient with cancer, would they prefer to be informed about the diagnosis are also asked. Results: 6566 subjects from various geographical regions of Turkey are participated in this survey. Participants’ median age were 33 years (range: 18–100), 53.3% were male. 57.7% of the participants would prefer to hide the cancer diagnosis from their first degree relatives. 54.8% of the participants had relatives with cancer and 69.9% of them said that the diagnosis had been told to the patient. The timing of the disclosure of the diagnosis were immediately in 71.5%, months after the diagnosis in 16.9% and in terminal stage in 9% of the patients. 62.8% of these patients are told to be died from cancer. When their overall opinion on cancer is asked, 76.5% were optimistic, 16.3% were pessimistic and did not believe the medicine, and 2.9% had both positive and negative opinions. Logistic regression analyses showed that 1) younger subjects; female subjects; subjects with lower education levels; subjects having a relative with cancer diagnosis which had not been revealed to the patient or revealed late in the course of the disease, or the patient had been died; subjects with pessimistic opinions about the treatment of the cancer were likely to hide the cancer diagnosis form their first degree relatives. 2) Elder subjects; subjects with lower education levels; subjects having a relative with cancer diagnosis which had been revealed to the patient; subjects having a relative with cancer diagnosis who died from cancer, subjects optimistic about cancer treatment; subjects preferring the diagnosis be hidden from patients were preferring not to be informed about the diagnosis if they were to have cancer. Conclusions: These results are comperable with reports form Eastern Europe and Asian countries. No significant financial relationships to disclose.
Individualized versus fixed dosing of L-asparaginase during intensification therapy in children treated on Dana-Farber Cancer Institute (DFCI) ALL Consortium Protocol 00–001
Authors: Waghorne C. , Stevenson K. E. , Neuberg D. S. , Sallan S. E. , Relling M. V. , Supko J. G. , Kutok J. , Silverman L. B. 
Published: March 2020

20000 Background: Asparaginase (ASP) is an important agent in the treatment of ALL, but is associated with multiple toxicities. In an attempt to reduce toxicity and improve ASP tolerability, we investigated individualizing the dose to maintain nadir serum ASP levels at the minimum concentration (0.01 - 0.014 IU/ml) required to achieve asparagine depletion. Methods: 399 children (1–18 years) with newly diagnosed ALL were randomized to receive intramuscular E.coli ASP either as fixed dose (FD) (N=201; 25,000 IU/m2/week) or individualized dose (ID) (N=198; 12,500 IU/m2/week starting dose, adjusted up or down every 3 weeks based upon nadir serum ASP level) for 30 weeks during post-induction intensification. We report here on 365 randomized patients (pts) who had 7-day nadir ASP levels measured (185 FD and 180 ID). Serum ASP levels were measured prior to ASP doses 2, 4 and every third subsequent dose. ASP-antibodies (ab) were measured every six weeks. Results: The median dose for ID pts was17,500 IU/m2 (range 6,000–28,000 IU/m2). The median ASP concentration was 0.11 IU/ml (range < 0.025- 2.16 IU/ml) for FD (N=1190 samples) and 0.08 IU/ml (range < 0.025–0.74 IU/ml) for ID (N= 1238 samples) (p<0.01). The interpatient variability in ASP concentration was smaller for ID vs. FD at all 10 time points measured. The proportion of pts who had detectable E.coli-ASP antibodies did not differ between the two arms (35% FD vs. 40% ID) (p= 0.33). The median ASP concentration was lower for ab-positive pts (0.08 IU/ml vs. 0.1 IU/ml, (p<0.01). Toxicity was similar in the two arms: local allergy: 6% FD vs. 8% ID (p= 0.55); systemic allergy: 12% FD vs. 14% ID (p= 0.54); pancreatitis: 5% FD vs. 7% ID (p= 0.66); thrombosis: 8% FD vs. 7% ID (p= 0.84). No association was observed between nadir ASP levels and either pancreatitis or thrombosis. Conclusions: Individualized dosing of E.coli ASP during intensification therapy reduced peak nadir ASP levels and interpatient variability but did not significantly decrease the incidence of ASP-related toxicity. Longer follow-up is necessary to determine event-free survival of the randomized pts. No significant financial relationships to disclose.
Findings from the screening echocardiograms performed on survivors of childhood cancer treated with anthracyclines and/or chest radiation
Authors: Andolina J. , Dilley K. J. 
Published: March 2020

20001 Background: Treatment with anthracyclines or chest radiation confers an increased risk of cardiomyopathy persisting for years after treatment ends. The Children’s Oncology Group (COG) has created guidelines for how often to screen cardiac function in long-term survivors of pediatric cancers based on age at treatment and total cumulative dose of anthracyclines. The objective was to examine the findings from a screening program using these guidelines. Methods: Medical record reviews were performed for all patients ever seen in the past 10 years in the long-term follow-up (LTFU) program at a single institution. Reviews examined treatment variables such as diagnosis, age at diagnosis and anthracycline cumulative dose as well as the shortening fraction (SF) from any echocardiogram (echo) performed as a screening study at =4 years from diagnosis (LTFU screening echo). Analyses include Chi-square and logistic regression. Results: 365 patients seen in the LTFU program at =5 years from diagnosis were considered at risk for cardiomyopathy due to anthracycline therapy or radiation exposure to the chest (including total body irradiation). Patients were 56.4% male and 65.5% white. Acute leukemia, neuroblastoma, Wilm’s tumor and lymphoma made up 82.2% of the diagnoses. 312/365 (85.5%) had ever had an LTFU screening echo. Younger age group at treatment as divided in the COG guidelines (<1y, 1–4y, =5y) was associated with likelihood of ever having an LTFU screening echo (p=0.018). 25/312 (8.0%) ever had a SF <28% in one of those LTFU studies. Only 5 of those 25 had an abnormal echo prior to presenting to LTFU. Age group at treatment was not significantly associated with likelihood of a SF <28% (p=0.939), but anthracycline dose of =250 mg/m2 was associated (OR 5.9, 95% CI 2.3–15.3). Radiation exposure, stem cell transplant and history of relapse were not associated with SF <28%, but prior abnormal echo was associated (p=0.032 exact). Cardiology referral was more likely in patients who ever had a SF <28% (p<0.001). Conclusions: Only 8% of patients being screened in a LTFU program for anthracycline-induced cardiomyopathy ever had a SF <28%. Further exploration of whether the age- and dose- stratified screening guidelines can be simplified is warranted. No significant financial relationships to disclose.
Demographics, clinical profile, management, and outcome of retinoblastoma in a tertiary care center in southern India
Authors: Reddy V. P. , Honavar S. G. , Shome D. , Shah K. , Naik M. N. , Rao R. 
Published: March 2020

20011 Background: Retinoblastoma is the most common malignant intraocular tumor in children. The estimated incidence of retinoblastoma in India is about 2,000 a year. However, there is scant data on the clinical manifestations and outcome of retinoblastoma in India. Methods: In this retrospective case series, the medical records of 460 consecutive cases of retinoblastoma from January 1990 to December 2004 were analyzed for demographics, clinical profile, treatment and outcome (survival, organ and function salvage). Results: An integrated Ocular Oncology Service was established at the treatment center in the year 2000 and a specialized Children’s Eye Cancer Center was founded in 2004. The annual referral increased from <20 a year before 2000 to 38 in 2000, and 120 in 2005. Two hundred and six (45%) patients were economically underprivileged. A majority (303, 66%) presented <3 years of age. There were 277 (60%) males. Although 188 (41%) were bilateral, family history was forthcoming in only 19 (4%). Of 648 involved eyes, 531 (82%) eyes were symptomatic. Leucocoria (71%) was the most common symptom, followed by visual loss (12%), eyelid edema or proptosis (7%), squint (6%), pain (2%), redness (2%), enlarged eyeball (2%), or shrunken eyeball (1%). The tumor was intraocular in 609 (94%) eyes while 39 (6%) were extraocular. Enucleation was the most common primary treatment for intraocular retinoblastoma (236 of 451, 52%), followed by chemoreduction coupled with focal therapy (26%), focal therapy alone (11%), external beam radiation (55) or chemotherapy alone (4%). Histopathologic risk factors predictive of metastasis were found in 152 of 277 (55%) eyes that underwent enucleation. Chemoreduction with focal therapy resulted in eye and vision salvage in 109 of 118 (92%). At the final follow-up (minimum 24 months), 434 (94%) were alive and well. Conclusions: Retinoblastoma has excellent prognosis for survival, eye salvage and vision salvage with the current management modalities. An integrated approach involving a team of a pediatric oncologist and an ocular oncologist at a comprehensive tertiary care center may augment referrals and help implement systematic treatment strategies. No significant financial relationships to disclose.
Comparative study of safety and efficacy of imatinib mesylate therapy in pediatric and adult chronic myeloid leukemia
Authors: Raizada N. , Sagar T. , Ramanan S. 
Published: March 2020

20016 Background: Chronic Myeloid Leukemia (CML) is one of the rare pediatric cancers. Imatinib is now the standard of care in adult CML (ACML) with newer compounds being investigated to overcome the burden of Imatinib resistance. Pediatric CML (PCML) has been an area little explored and effective strategies are not yet defined. Although, allogenic hematopoietic stem cell transplantation (HSCT) still remains the gold-standard treatment, the choice of drug in the subset in which HSCT is not a suitable option remains to be determined. Methods: This was a single-institution prospective study conducted from April 2004-March 2006, analyzing and comparing 293 Philadelphia chromosome (PH) positive CML patients in pediatric and adolescent subsets (i.e. age =18 years) not eligible for allogenic HSCT with ACML. After obtaining a written informed consent, a starting dose of 400 mg/m2/d Imatinib mesylate was administered in adults, whereas in pediatric and adolescents it was 400 mg/m2/d if the body surface area (BSA) was <1 m2, or 400 mg/d if BSA was >1m2. Results: 27 patients were in the age group =18 years; male to female ratio was 1.07:1. Gender ratio in 266 ACML patients showed a male preponderance (2.5:1). The mean age in ACML was 37.4 years. In pediatric subsets, a trend toward CML in adolescents was observed with mean age 14.85 years. Majority of the patients were in chronic phase (81.5% PCML and 85.7% ACML) with overall 93% patients receiving prior hydroxyurea as a cytoreductive agent. An unusual finding was higher incidence of Hypodiploidy (significance undetermined) and 5 patients had double PH. 80.1% ACML patients achieved complete hematological response, but it was significantly lower (59.3%) in PCML. 39.5% ACML achieved major cytogenetic response which was less than most published western data. Hematologic and non-hematologic toxicities (GI, dermatological etc) were found to be higher in ACML. Low toxicities in PCML were attributed to good tolerance to Imatinib therapy; however a higher dropout rate in pediatric subsets was possibly due to poor social and parental support. Conclusion: We conclude that imatinib mesylate is both safe and efficacious drug for ACML, however further research is warranted in pediatric and adolescent population to establish its efficacy. No significant financial relationships to disclose.
Retrospective study of relapsed ALL in a single institution in Brazil
Authors: Marconcini J. F. , Gomes C. F. , Delbuono E. , Costa V. , Pacheco C. D. , Seber A. , Lee M. M. 
Published: March 2020

20018 Background: With contemporary protocols, 25–30% of children with ALL who achieve first complete remission (CR1) are expected to relapse. Although the majority of patients can achieve a second complete remission (CR2) with re-induction chemotherapy, only a few will maintain prolonged clinical remission. To study the pattern of ALL relapse in our institution, we performed a retrospective analysis of such events between 1994 and 2006. Methods: In the study period, 65 out of 292 (22%) patients treated at our institution for ALL suffered isolated or combined relapse. Median age was 7.2 years (range 0.4–18.2 years); 65% were male. Patients were analyzed according to immunophenotype, WBC, site of relapse and time to relapse. Kaplan-Meier life-table analyses were used to estimate survival; differences were assessed by the log-rank test. Results: Of 63 relapsed ALL that were immunophenotyped, 65% were B-cell precursors and 35% were T-cell. WBC was >50,000/mm3 in 47% of patients; 54% of them had isolated bone marrow (BM) relapse, 23% combined relapse and 23% isolated extramedullary (EM) relapse (11CNS and 4 testicular relapse); 58% had very early relapse (VER) (<18 months from CR1), 17% early relapse (ER) (18–30 months from CR1) and 25% late relapse (LR) (>30 months from CR1). The therapeutic approach was chemotherapy in 60 patients and BMT in five. CR2 was achieved in 63% of patients. Of these, 35% had a second relapse. Death rate was 66% with median follow-up of 5,3 months; 40% had cumulative survival rate = 4 years. Initial imunophenotype and WBC did not affect outcome. Patients with isolated EM relapse presented a significant superior outcome when compared with those with combined relapse (p=0.024). There was no difference in survival between isolated BM and combined relapse. As for the time to relapse, there was significant inferior outcome for patients with VER when compared with ER (p=0.0089) and LR (p=0.0041). However, there was no difference in survival between ER and LR group. Conclusions: In our casuistic, time to relapse was the main predictor of outcome. Despite continuous improvement in therapy of childhood ALL, survival rate of relapsed patients remains disappointing. No significant financial relationships to disclose.
The efficacy of I-131 metaiodobenzylguanidine (MIBG) treatment in previously heavily treated stage IV neuroblastoma patients (age more than 1 year): Preliminary experiences
Authors: Chotipanich C. , Cheuamsamakkee K. , Changmuang W. , Chouplywech P. , Wittayachokkitikhum S. , Musikarat S. , Sritara C. , Utamakul C. , Pakakasama S. , Hongeng S. 
Published: March 2020

20025 Background: The outcome of advanced stage neuroblastoma patients with multiple relapsed or refractory diseases is very dismal. We therefore would like to study the efficacy and the safety of I-131 MIBG treatment in this group of patients. Method: A retrospective study of six stage IV neuroblastoma patients (pts) (2 males and 4 females), age at the diagnosis range 3 to 8 years from January 2005 to December 2006 were studied. All pts were previously treated with multiple regimens of chemotherapy, high-dose chemotherapy with autologous peripheral stem cells (PBSCs) rescue, salvage surgery, and local radiation ( table ). All these patients had relapsed or refractory disease at the time of I-131 MIBG treatment. The therapeutic dose of I-131 MIBG activity per course was given on the basis of weight, the hematological parameter, and tumor response assessment. The cycle of treatment was more 4 weeks apart. The treatment response was evaluated by imaging. and neuron-specific enolase (NSE) levels. Results: A total of 21 courses of I-131 MIBG were administered: one patient received one course, two received three courses, two received four courses and one received six courses. The median therapeutic dose of I-131 MIBG was 5.5 GBq (range; 1.1–5.5). Median duration of response was 10 months (range, 1–19). A partial response achieved in 1, and stable response in 5 patients. Pain relief was observed in 1/1 patients with bone pain. The most common side effect found was thrombocytopenia which became more severe with increasing number of course, grade 2 thrombocytopenia occurring in 4/6 patients over 3 courses of therapy. Three children died whereas three are still alive. There is no morbidity from the therapy. Conclusion: It can be concluded that MIBG treatment is effective and less toxic in patients with relapsed or refractory neuroblastoma and further studies of the role of I-131 MIBG treatment in advanced neuroblastoma in Thailand are needed. [Table: see text] No significant financial relationships to disclose.
Profile of infantile malignancies at tertiary cancer center—A study from south India
Authors: HS M. , Kumari B. Aruna , Appaji L. , Attili S. V. , Padma D. , Vidya J. 
Published: March 2020

20026 Background: Infantile malignancies are peculiar in the way they present with lot of diversity and had poor prognosis compared to other pediatric malignancies. The spectrum of malignancies had a great regional variability owing to the environmental and genetic differences (both aquired, maternal and paternal). Methods: It is a retrospective data analysis conducted at a tertiary care cancer center, Bangalore, India. The institute has an annual attendance of 16,000 new cases with reasonably good follow-up. The contribution of pediatric malignancies is 18%. The details were collected from the case records and percentages were calculated for the variables. Results: Between 2003–2006 we diagnosed 1,798 pediatric tumors. Of them 198 (11%) are infantile malignancies. The commonest diagnosis at our center is leukemia (30% of all infantile malignancies). The main types of leukemia are ALL-80%, AML-13%, and CML-7%. Other hematological malignancies are lymphomas- 2%, myelo proliferative disorders and Langerhan Cell histiocytosis-3% each. The next common diagnosis is benign neoplasms, wrongly diagnosed as malignant at the secondary referral center which contributed 16% of all cases. The reminder 46% is solid malignancies. In the decreasing frequency the incidences are Wilm’s tumor-12%, neuroblastoma-10%, germ cell tumors-8%, retinoblastoma- 6% CNS malignancies and 3% hepatoblastoma -2%. The reminders are other rare malignancies. Conclusion: The contribution of infantile malignancies at our center is relatively higher compared to the west. Similarly Relative contribution of AML to the all hematological malignancies and neurblastoma & CNS tumors to solid malignancies is less compared to the existing literature. Wilm’s tumor and ALL diagnosed more frequently than expected in our population. All these findings together suggest that south Indian population had a different spectrum of infantile malignancies compared to rest of the world and their genetic and environmental risk factors need further exploration. No significant financial relationships to disclose.