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  • 1
    Language: English
    In: International journal of cancer, 2014-10-15, Vol.135 (8), p.1764-1773
    Description: With continuing improvements in the successful treatment of pediatric malignancies, long term survivors of pediatric cancers and their providers are faced with new oncologic issues regarding long‐term morbidities. As pediatric cancer survivors have matured into adulthood, the development of secondary malignancies has become a significant issue for these patients. Whether a consequence of treatment for the patient's original cancer, such as chemotherapy, ionizing radiation, or hematopoietic stem cell transplantation, secondary malignancies now present patients and providers with new challenges regarding treatment, surveillance and counseling. We review the major risk factors for secondary malignancies in pediatric cancer survivors, with particular emphasis on important molecular and cytogenetic risk factors, both inherited and acquired. We conclude with a discussion of recommendations for surveillance and counseling of these patients.
    Subject(s): secondary malignancy ; childhood cancer survivor ; long‐term morbidities ; Biological and medical sciences ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Medical sciences ; Tumors ; Antineoplastic Agents - adverse effects ; Early Detection of Cancer ; Neoplasms, Second Primary - chemically induced ; Genes, Neoplasm ; Humans ; Risk Factors ; Survivors ; Antineoplastic Agents - therapeutic use ; Mutation ; Neoplasms, Second Primary - genetics ; Neoplasms, Second Primary - diagnosis ; Cancer survivors ; Pediatrics ; Chemotherapy ; Ionizing radiation ; Hematopoietic stem cells ; Cancer ; Cancer in children
    ISSN: 0020-7136
    E-ISSN: 1097-0215
    Source: Alma/SFX Local Collection
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  • 2
    Language: English
    In: Journal of clinical oncology, 2013-03-20, Vol.31 (9), p.1239-1247
    Description: As more young female patients with cancer survive their primary disease, concerns about reproductive health related to primary therapy gain relevance. Cancer therapy can often affect reproductive organs, leading to impaired pubertal development, hormonal regulation, fertility, and sexual function, affecting quality of life. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) are evidence-based recommendations for screening and management of late effects of therapeutic exposures. The guidelines are updated every 2 years by a multidisciplinary panel based on current literature review and expert consensus. This review summarizes the current task force recommendations for the assessment and management of female reproductive complications after treatment for childhood, adolescent, and young adult cancers. Experimental pretreatment as well as post-treatment fertility preservation strategies, including barriers and ethical considerations, which are not included in the COG-LTFU Guidelines, are also discussed. Ongoing research will continue to inform COG-LTFU Guideline recommendations for follow-up care of female survivors of childhood cancer to improve their health and quality of life.
    Subject(s): Biological and medical sciences ; Medical sciences ; Tumors ; Sexual Dysfunction, Physiological - therapy ; Reproductive Health ; Humans ; Puberty, Precocious - drug therapy ; Young Adult ; Neoplasms - therapy ; Gonadal Disorders - diagnosis ; Infertility, Female - etiology ; Female ; Hypogonadism - diagnosis ; Child ; Ethics, Medical ; Puberty, Precocious - diagnosis ; Gonadal Disorders - therapy ; Sexual Dysfunction, Physiological - etiology ; Aftercare ; Adolescent ; Quality of Life ; Hypogonadism - therapy ; Puberty, Precocious - etiology ; Hypogonadism - etiology ; Infertility, Female - diagnosis ; Infertility, Female - therapy ; Practice Guidelines as Topic ; Sexual Dysfunction, Physiological - diagnosis ; Index Medicus ; Gdln2 ; Special ; Pedi24
    ISSN: 0732-183X
    E-ISSN: 1527-7755
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 3
    Language: English
    In: Pediatric blood & cancer, 2016-08, Vol.63 (8), p.1332-1338
    Description: Side effects of tyrosine kinase inhibitor (TKI) treatment vary in children and adults with chronic myelogenous leukemia (CML). As children have a much longer life expectancy than adults, TKI therapy may continue for decades and with long‐term consequences that differ from adults. Children may develop endocrinopathies related to “off‐target” effects of TKIs, such as delayed growth, changes in bone metabolism, thyroid abnormalities, and effects on puberty and fertility. These endocrinopathies present additional challenges for pediatric patients with CML. This review critically evaluates the literature on long‐term endocrine side effects of TKIs in the pediatric CML population and provides suggested recommendations.
    Subject(s): growth ; CML ; TKI ; children ; endocrine ; Endocrine System Diseases - chemically induced ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy ; Antineoplastic Agents - therapeutic use ; Protein Kinase Inhibitors - adverse effects ; Bone Remodeling - drug effects ; Imatinib Mesylate - therapeutic use ; Antineoplastic Agents - adverse effects ; Imatinib Mesylate - adverse effects ; Endocrine System - drug effects ; Imidazoles - therapeutic use ; Adrenal Glands - drug effects ; Child ; Pyridazines - adverse effects ; Pyridazines - therapeutic use ; Thyroid Gland - drug effects ; Imidazoles - adverse effects ; Dasatinib - therapeutic use ; Glucose Metabolism Disorders - chemically induced ; Endocrine System - pathology ; Protein Kinase Inhibitors - therapeutic use ; Pyrimidines - therapeutic use ; Fusion Proteins, bcr-abl - antagonists & inhibitors ; Pyrimidines - adverse effects ; Dasatinib - adverse effects ; Quinolines - therapeutic use ; Aniline Compounds - therapeutic use ; Aniline Compounds - adverse effects ; Nitriles - adverse effects ; Quinolines - adverse effects ; Nitriles - therapeutic use ; Tyrosine ; Physiological aspects ; Phenols ; Chronic myeloid leukemia ; Children ; Health aspects ; Index Medicus
    ISSN: 1545-5009
    E-ISSN: 1545-5017
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 4
    Language: English
    In: Journal of clinical oncology, 2012-09-20, Vol.30 (27), p.3408-3416
    Description: The majority of children, adolescents, and young adults diagnosed with cancer will become long-term survivors. Although cancer therapy is associated with many adverse effects, one of the primary concerns of young male cancer survivors is reproductive health. Future fertility is often the focus of concern; however, it must be recognized that all aspects of male health, including pubertal development, testosterone production, and sexual function, can be impaired by cancer therapy. Although pretreatment strategies to preserve reproductive health have been beneficial to some male patients, many survivors remain at risk for long-term reproductive complications. Understanding risk factors and monitoring the reproductive health of young male survivors are important aspects of follow-up care. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) were created by the COG to provide recommendations for follow-up care of survivors at risk for long-term complications. The male health task force of the COG-LTFU Guidelines, composed of pediatric oncologists, endocrinologists, nurse practitioners, a urologist, and a radiation oncologist, is responsible for updating the COG-LTFU Guidelines every 2 years based on literature review and expert consensus. This review summarizes current task force recommendations for the assessment and management of male reproductive complications after treatment for childhood, adolescent, and young adult cancers. Issues related to male health that are being investigated, but currently not included in the COG-LTFU Guidelines, are also discussed. Ongoing investigation will inform future COG-LTFU Guideline recommendations for follow-up care to improve health and quality of life for male survivors.
    Subject(s): Biological and medical sciences ; Medical sciences ; Tumors ; Puberty, Precocious - therapy ; Sexual Dysfunction, Physiological - therapy ; Reproductive Health ; Humans ; Infertility, Male - etiology ; Male ; Young Adult ; Neoplasms - complications ; Neoplasms - therapy ; Cryopreservation ; Puberty, Delayed - etiology ; Gonadal Disorders - diagnosis ; Testosterone - deficiency ; Adult ; Infertility, Male - therapy ; Child ; Infertility, Male - diagnosis ; Puberty, Delayed - therapy ; Neoplasms - rehabilitation ; Gonadal Disorders - etiology ; Risk Factors ; Survivors ; Puberty, Delayed - diagnosis ; Puberty, Precocious - diagnosis ; Gonadal Disorders - therapy ; Sexual Dysfunction, Physiological - etiology ; Adolescent ; Puberty, Precocious - etiology ; Semen Preservation ; Sexual Dysfunction, Physiological - diagnosis ; Index Medicus ; Pedi24 ; Review
    ISSN: 0732-183X
    E-ISSN: 1527-7755
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 5
    Language: English
    In: Pediatric blood & cancer, 2019-05, Vol.66 (5), p.e27598-n/a
    Description: Background Identification of an organism is the gold standard for the diagnosis of fungal infection; however, we have previously shown that invasive procedures infrequently lead to a change in management in children with cancer or who have undergone stem cell transplant with suspected respiratory tract invasive fungal infection (RT‐IFI). There is also a paucity of data on the cost of RT‐IFI in this population. We therefore compared the costs of RT‐IFI diagnosed based on CT scan alone versus those who underwent a bronchoalveolar lavage (BAL) or respiratory tract biopsy (RTB). Procedure We collected cost data on patients at a single center undergoing chemotherapy or who were post‐hematopoietic stem cell transplant (HSCT) and were suspected of having RT‐IFI between 2007 and 2012. Cost data were included for 14 days from the day of their diagnostic CT scan or procedure. Results Cost data were available for 76 patients. Thirty‐six patients were diagnosed with suspected RT‐IFI based on CT only, and 40 patients underwent BAL or RTB. Costs related to chest X‐rays (CXRs), inpatient/intensive care unit (ICU) beds, anesthesia, operating room (OR) time, and procedures were significantly higher in the BAL/RTB group versus CT scan group (all P 〈 0.01). Costs related to CT scans were significantly higher in the CT scan group (P = 0.0002). Overall costs were significantly higher for patients who underwent BAL or RTB versus CT scan only (P 〈 0.0001). Conclusion Our previous data showed that BAL and RTB infrequently led to a change in management in this population. We now demonstrate that this strategy is costly as well.
    Subject(s): stem cell transplant ; invasive fungal infection ; pediatric oncology ; cost analysis ; bronchoalveolar lavage ; lung biopsy ; CT imaging ; Antifungal agents ; Mycoses ; Diagnostic imaging ; Transplantation ; Hematopoietic stem cells ; Chemotherapy ; Analysis ; Stem cells ; Medical care ; Health aspects ; Cancer ; Quality management ; Index Medicus
    ISSN: 1545-5009
    E-ISSN: 1545-5017
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 6
    Language: English
    In: Pediatric blood & cancer, 2017-12, Vol.64 (12), p.e26703-n/a
    Subject(s): Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Protein-Tyrosine Kinases ; Child ; Imatinib Mesylate ; Humans ; Antimitotic agents ; Tyrosine ; Care and treatment ; Child development ; Antineoplastic agents ; Cancer ; Index Medicus
    ISSN: 1545-5009
    E-ISSN: 1545-5017
    Source: Alma/SFX Local Collection
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  • 7
    Language: English
    In: Leukemia, 2020-09, Vol.34 (9), p.2279-2284
    Description: Our concept of cancer latency, the interval from when a cancer starts until it is diagnosed, has changed dramatically. A prior widely-used definition was the interval between an exposure to a cancer-causing substance and cancer diagnosis. However, this definition does not accurately reflect current knowledge of how most cancers develop assuming, mostly incorrectly, one exposure is the sole cause of a cancer, ignoring the possibility the cancer being considered would have developed anyway but that the exposure accelerated cancer development and eliding the randomness in when a cancer is diagnosed. We show, using chronic myeloid leukaemia as a model, that defining cancer latency is not as simple as it once seemed. It is difficult or impossible to know at which event or mutation to start to clock to measure cancer latency. It is equally difficult to know when to stop the clock given the stochastic nature of when cancers are diagnosed. Importantly, even in genetically-identical twins with the same driver mutation intervals to develop cancer vary substantially. And we discuss other confonders. Clearly we need a new definition of cancer latency or we need to abandon the concept of cancer latency in the modern era of cancer biology.
    Subject(s): Leukemia, Myelogenous, Chronic, BCR-ABL Positive - diagnosis ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - pathology ; Disease Progression ; Development and progression ; Genetic aspects ; Chronic myeloid leukemia ; Gene mutations ; Health aspects ; Index Medicus
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 8
    Language: English
    In: JAMA : the journal of the American Medical Association, 2007-03-21, Vol.297 (11), p.1207-1215
    Description: CONTEXT Little is known about the incidence of secondary neoplasms after 15 to 20 years in children and adolescents who were treated for acute lymphoblastic leukemia. OBJECTIVES To investigate the cumulative incidence of secondary neoplasms in pediatric patients treated for acute lymphoblastic leukemia over 30 years and to characterize late-occurring tumors. DESIGN, SETTING, AND PATIENTS Retrospective study of 2169 patients with acute lymphoblastic leukemia treated between 1962 and 1998 at St Jude Children's Research Hospital, Memphis, Tenn, who achieved complete remission and had a median follow-up time of 18.7 years (range, 2.4-41.3 years). MAIN OUTCOME MEASURES Cumulative incidences of secondary neoplasms in first remission and standard incidence ratios of observed rates compared with rates of cancer development in the general US population. RESULTS Secondary neoplasms developed as the first event in 123 patients and comprised 46 myeloid malignancies, 3 lymphomas, 14 basal cell carcinomas, 16 other carcinomas, 6 sarcomas, 16 meningiomas, and 22 other brain tumors. The cumulative incidence of secondary neoplasm was 4.17% (SE, 0.46%) at 15 years and increased substantially after 20 years, reaching 10.85% (SE, 1.27%) at 30 years. When meningiomas and basal cell carcinomas were excluded, the overall cumulative incidence was 3.99% (SE, 0.44%) at 15 years and 6.27% (SE, 0.83%) at 30 years, representing a 13.5-fold increase in overall risk compared with the general population. The cumulative incidence of each tumor type at 30 years was 2.19% (SE, 0.32%) for myeloid malignancy, 0.17% (SE, 0.10%) for lymphoma, 3.00% (SE, 0.59%) for brain tumor, 4.91% (SE, 1.04%) for carcinoma, and 0.57% (SE, 0.37%) for sarcoma. CONCLUSIONS The cumulative incidence of secondary neoplasms increases steadily over 30 years after treatment of acute lymphoblastic leukemia. Although the majority of the late-occurring secondary neoplasms are low-grade tumors, the increase in incidence of more aggressive malignant neoplasms is significantly higher than expected in the general population. These results suggest that lifelong follow-up of acute lymphoblastic leukemia survivors is needed to ascertain the full impact of treatment and other leukemia-related factors on secondary neoplasm development.
    Subject(s): Hematologic and hematopoietic diseases ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Biological and medical sciences ; General aspects ; Medical sciences ; Follow-Up Studies ; Humans ; Risk Factors ; Survivors ; Remission Induction ; Incidence ; Neoplasms, Second Primary - epidemiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy ; Time Factors ; Adolescent ; Adult ; Retrospective Studies ; Child ; Care and treatment ; Acute lymphocytic leukemia ; Research ; Risk factors ; Tumors ; Cancer in children ; Index Medicus ; Abridged Index Medicus
    ISSN: 0098-7484
    E-ISSN: 1538-3598
    Source: American Medical Association Journals Backfile (through 1997)
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 9
    Language: English
    In: Leukemia, 2018-11, Vol.32 (11), p.2316-2325
    Description: The survival of pediatric patients with multiply relapsed and/or refractory (R/R) B-cell acute lymphoblastic leukemia has historically been very poor; however, data are limited in the current era. We conducted a retrospective study to determine the outcome of multiply R/R childhood B-ALL treated at 24 TACL institutions between 2005 and 2013. Patient information, treatment, and response were collected. Prognostic factors influencing the complete remission (CR) rate and event-free survival (EFS) were analyzed. The analytic set included 578 salvage treatment attempts among 325 patients. CR rates (mean ± SE) were 51 ± 4% for patients with bone marrow R/R B-ALL who underwent a second salvage attempt, 37 ± 6% for a third attempt, and 31 ± 6% for the fourth through eighth attempts combined. For patients achieving a CR after their second, third, and fourth through eighth attempts, the 2 year EFS was 41 ± 6%, 13 ± 7%, and 27 ± 13% respectively. Our results showed slight improvement when compared to previous studies. This is the largest and most recent study to date that evaluates the outcome of this patient population. Our data will provide detailed reference for the evaluation of new agents being developed for childhood B-ALL.
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 10
    Language: English
    In: Blood, 2019-05-30, Vol.133 (22), p.2374-2384
    Description: Evidence-based recommendations have been established for treatment of chronic myeloid leukemia (CML) in adults treated with tyrosine kinase inhibitors (TKIs), but the rarity of this leukemia in children and adolescents makes it challenging to develop similar recommendations in pediatrics. In addition to imatinib, which was approved for pediatric CML in 2003, the second-generation TKIs dasatinib and nilotinib were recently approved for use in children, expanding the therapeutic options and pushing allogeneic stem cell transplantation to a third-line treatment of most pediatric cases. Yet, without sufficient data on efficacy and safety specific to pediatric patients, the selection of a TKI continues to rely on clinical experience in adults. Here, we present 4 case scenarios highlighting common yet challenging issues encountered in the treatment of pediatric CML (suboptimal response, poor treatment adherence, growth retardation, and presentation in advanced phases). Limited experience with very young children, the transition of teenagers to adult medicine, and the goal of achieving treatment-free remission for this rare leukemia are additional significant obstacles that require further clinical investigation through international collaboration.
    Subject(s): Allografts ; Protein Kinase Inhibitors - therapeutic use ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - pathology ; Adolescent ; Child, Preschool ; Hematopoietic Stem Cell Transplantation ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - metabolism ; Female ; Male ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy ; Child ; Index Medicus ; Abridged Index Medicus
    ISSN: 0006-4971
    E-ISSN: 1528-0020
    Source: HighWire Press (Free Journals)
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: American Society of Hematology
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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