Katzenstein, Howard M.
Petricca, Sarah
Ricketts, Richard
Wasilewski-Masker, Karen
Powell, Christie
Rapkin, Louis
George, Bradley
Woods, William G.
Olson, Thomas A.
Background. Local control is essential for the successful treatment of pediatric solid tumors. Complete excision is often not possible and local control therapies are limited. Intracavitary cisplatin (IC-CDDP) may be utilized to supplement local control. The aim of the study was to determine the toxicity and efficacy of locally instilled intracavitary cisplatin in patients with recurrent tumors in closed body cavities. Procedure. From 2001 to 2009, 12 patients (1-20 years) with recurrent or unresectable malignant tumors were treated with IC-CDDP. Nine had pulmonary lesions. Three patients had abdominal tumors. CDDP (200 mg/m(2)) was instilled by chest tube or Tenckhoff catheter. Patients were shifted every 15-30 min to allow distribution. After 4 hr, residual was drained by gravity. In 10/13 courses, sodium thiosulfate (STS) was administered to prevent nephrotoxicity. Three other patients received amifostine. Results. Malignant pleural effusions resolved in 5/7 patients. This response was temporary in three patients. No patients had ascites prior to treatment. Three patients are alive and disease-free, 18 months, 4 years, and 6 years from treatment. They also had surgery and chemotherapy. Transient renal toxicity was noted in most patients. One patient, treated with amifostine, had persistent renal dysfunction. Conclusions. IC-CDDP was effective in treating malignant pleural effusions and may be a palliative option for refractory disease. Long-term survival was achieved in two patients, treated at first diagnosis. The benefit of IC-CDDP in these patients is difficult to assess. Renal dysfunction is usually mild, and typically resolves, but warrants preventive measures with IC-CDDP therapy. Pediatr Blood Cancer. 2010;55:452-456. (C) 2010 Wiley-Liss, Inc.
Woodard, Paul
Carpenter, Paul A.
Davies, Stella M.
Gross, Thomas G.
He, Wensheng
Zhang, Mei-Jie
Horn, Biljana N.
Margolis, David A.
Perentesis, John P.
Sanders, Jean E.
Schultz, Kirk R.
Seber, Adriana
Woods, William G.
Eapen, Mary
We describe long-term disease-free survival (DFS) after unrelated donor bone marrow transplantation (BMT) for myelodysplastic syndrome (MDS) in <= 8 patients aged years. Forty-six patients had refractory cytopenia (RC), 55 refractory anemia with excess blasts (RAEB), and 17 refractory anemia with excess blasts in transformation (RAEB-t). Transplant-related mortality was higher after mismatched BMT (relative risk [RR] 3.29, P=.002). Disease recurrence was more likely with advanced stages of MDS at the time of BMT: RAEB (RR 6.50, P=.01) or RAEB-t (RR 11.00, P=.004). Treatment failure (recurrent disease or death from any cause; inverse of DFS) occurred in 68 patients. Treatment failure was higher after mismatched BMT (RR 2.79, P=.001) and in those with RAEB-t (RR 2.38, P=.02). Secondary MDS or chemotherapy prior to BMT was not associated with recurrence or treatment failure. Similarly, cytogenetic abnormalities were not associated with transplant outcomes. Eight-year DFS for patients with RC after matched and mismatched unrelated donor BMT was 65% and 40%, respectively. Corresponding DFS for patients with RAEB and RAEB-t was 48% and 28%, respectively. When a matched adult unrelated donor is available, BMT should be offered as first-line therapy, and children with RC can be expected to have the best outcome. Biol Blood Marrow Transplant 17: 723-728 (2011) (C) 2011 American Society for Blood and Marrow Transplantation
Pace, Betty
Wang, Winfred
Kulkarni, Roshni
Luban, Naomi
Johnson, Cage S.
Eckman, James
Lane, Peter
Woods, William G.
The American Society of Pediatric Hematology/Oncology Sickle Cell Summit brought together a broad range of constituencies to identify a unified approach to healthcare and research disparities for sickle cell disease. Recommendations included the following: (1) speak with a unified voice representing all constituencies; (2) optimize access to care from knowledgeable health care providers and create a medical home for all individuals with the disease; (3) utilize population-based surveillance to measure outcomes; (4) develop overall approaches to basic, translational, clinical, and health services research; (5) enhance the community role in advocacy, education, service, and fundraising. Taskforces were identified to effect implementation. Am. J. Hematol. 84:39-45, 2009. (C) 2008 Wiley-Liss, Inc.
Barrette, Stephane
Bernstein, Mark L.
Robison, Leslie L.
Samson, Yvan
Brossard, Josee
Weitzman, Sheila
Woods, William G.
Purpose A significant increase in the incidence of neuroblastoma occurred among a 5-year birth cohort (May 1989 to April 1994) during an active urinary screening program for its early detection. We examined the postscreening incidence of neuroblastoma in the subsequent 5-year birth cohort (May 1994 to April 1999), with follow-up to 2002, to determine whether the incidence remained increased. Patients and Methods We reviewed institutional records of patients diagnosed with neuroblastoma during the period from 1994 to 2002 who were born in 1994 to 1999 in the province of Quebec, as well as in the state of Minnesota and the province of Ontario, regions that had served as controls during the screening interval. We calculated and compared incidence rates during the 1994 to 2002 time period. Results For the 5-year birth cohort as a whole, the rate of newly diagnosed neuroblastoma was higher in Quebec than in the control populations of Minnesota and Ontario (standardized incidence ratio, 1.34; 95% CI, 1.03 to 1.70). However, in years 4 and 5 of the interval, population-based incidence declined to the same levels as those seen in the control areas. Conclusion The institution of a urinary screening program for neuroblastoma led to increased awareness of the diagnosis and an elevated rate of diagnosis even after the completion of the screening evaluation. However, this halo effect was transient, with diagnostic rates subsequently decreasing within the range seen in control populations.
Woods, William G.
Gao, Ru-Nie
Shuster, Jonathan J.
Robison, Leslie L.
Bernstein, Mark
Weitzman, Sheila
Bunin, Greta
Levy, Isra
Brossard, Josee
Dougherty, Geoffrey
Tuchman, Mendel
Lemieux, Bernard
Woods, William G.
Tuchman, Mendel
Bernstein, Mark L.
Leclerc, Jean-Marie
Brisson, L.
Look, Thomas
Brodeur, Garrett M.
Shimada, H.
Hann, H. L.
Robison, Leslie L.
Shuster, Jonathan J.
Lemieux, Bernard