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Pieters R. Role of the immune system in DILI; lessons learned from animal studies. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Van Bilsen J, De Zeeuw‐Brouwer M, Van Roest M, De Jong G, Pieters R, Houben G, Smit J. The prediction of the allergenicity food proteins by combining an in vitro and an in vivo model. Clin Transl Allergy 2015. [PMCID: PMC4412298 DOI: 10.1186/2045-7022-5-s3-p153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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den Hoed MAH, Klap BC, te Winkel ML, Pieters R, van Waas M, Neggers SJCMM, Boot AM, Blijdorp K, van Dorp W, Pluijm SMF, van den Heuvel-Eibrink MM. Bone mineral density after childhood cancer in 346 long-term adult survivors of childhood cancer. Osteoporos Int 2015; 26:521-9. [PMID: 25209410 DOI: 10.1007/s00198-014-2878-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 08/27/2014] [Indexed: 12/12/2022]
Abstract
SUMMARY More than 45 % of long-term childhood cancer survivors (CCS) were diagnosed with osteopenia. Our data suggest that greater awareness for osteopenia is warranted in long-term CCS, especially in survivors who are older than 30 years, male, and underweight and were treated with cranial-spinal radiotherapy and/or steroids. INTRODUCTION Osteopenia is a potential complication of childhood cancer treatment, but the magnitude of this problem in survivors is unknown. We examined (determinants of) bone mineral density (BMD) status in long-term survivors of adult childhood cancer. METHODS This retrospective single-centre cohort study included 346 subjects with the most common types of childhood cancer. Subjects had a median age at diagnosis of 7.0 years (range 0.1-16.8 years), a median age at follow-up of 24.5 years (range 18.0-47.6 years) and a median follow-up time of 16.7 years (range 5.6-39.9 years). Total body BMD (BMDTB) and BMD of the lumbar spine (BMDLS) were measured by dual X-ray absorptiometry. Osteopenia was defined as BMD standardized deviation score (SDS) below -1. RESULTS Survivors had a lower BMDTB and BMDLS (mean SDS -0.55; p<0.001 and -0.30; p<0.001, respectively) as compared to healthy peers. Osteopenia (BMDTB and/or BMDLS) was present in 45% of the survivors. Multivariate logistic regression analyses identified age at diagnosis<12 years, age>30 years at follow-up, male gender, underweight at follow-up and treatment with cranial-spinal radiotherapy or prednisone as independent prognostic factors for osteopenia. CONCLUSIONS This large cohort of childhood cancer survivors identified osteopenia in 45% of CCS. This indicates that greater awareness is warranted, especially in survivors who are older than 30 years, male, have underweight and were treated with cranial-spinal radiotherapy and/or steroids.
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den Hoed MAH, Lopez-Lopez E, te Winkel ML, Tissing W, de Rooij JDE, Gutierrez-Camino A, Garcia-Orad A, den Boer E, Pieters R, Pluijm SMF, de Jonge R, van den Heuvel-Eibrink MM. Genetic and metabolic determinants of methotrexate-induced mucositis in pediatric acute lymphoblastic leukemia. THE PHARMACOGENOMICS JOURNAL 2014; 15:248-54. [PMID: 25348617 DOI: 10.1038/tpj.2014.63] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 09/01/2014] [Accepted: 09/05/2014] [Indexed: 11/09/2022]
Abstract
Methotrexate (MTX) is an effective and toxic chemotherapeutic drug in the treatment of pediatric acute lymphoblastic leukemia(ALL). In this prospective study, we aimed to identify metabolic and genetic determinants of MTX toxicity. One hundred and thirty-four Dutch pediatric ALL patients were treated with four high infusions MTX (HD-MTX: 5 g m(-2)) every other week according to the DCOG-ALL-10 protocol. Mucositis (National Cancer Institute grade ⩾ 3) was the most frequent occurring toxicity during the HD-MTX phase (20%) and occurred especially after the first MTX course. Mucositis was not associated with plasma MTX, plasma folate or plasma homocysteine levels. Patients with mucositis had higher erythrocyte folate levels at the start of protocol M than patients without mucositis (median 1.4 vs 1.2 μmol l(-1), P<0.008), this could reflect an increased MTX uptake in mucosal cells of patients with mucositis. From 17 single-nucleotide polymorphisms in the MTX pathway, only patients with the wild-type variant of rs7317112 SNP in the ABCC4 gene had more mucositis (AA (39%) vs AG/GG (15%), P=0.016). We found no evidence that erythrocyte folate levels mediate in the association between the rs7317112 and mucositis.
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Teunis M, Kegler D, Raaijmakers J, Van de Valk J, Vandebriel R, Woutersen R, Pieters R, Krul C. SLIM: A smart way from innovations to humans; case studies to accelerate the acceptance and implementation of alternative methods to animal experiments for safety assessment. PHARMANUTRITION 2014. [DOI: 10.1016/j.phanu.2013.11.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Warris LT, van den Heuvel-Eibrink MM, den Hoed MAH, Aarsen FK, Pieters R, van den Akker ELT. Does dexamethasone induce more neuropsychological side effects than prednisone in pediatric acute lymphoblastic leukemia? A systematic review. Pediatr Blood Cancer 2014; 61:1313-8. [PMID: 24532490 DOI: 10.1002/pbc.24988] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 01/23/2014] [Indexed: 11/09/2022]
Abstract
Steroid-induced neuropsychological side effects impact quality of life in children with acute lymphoblastic leukemia. Dexamethasone induces more metabolic side effects than prednisone. To evaluate whether dexamethasone also leads to more neuropsychological side effects, we reviewed all available literature. Randomized controlled trials with neuropsychological function as the primary or secondary outcome did not show clinically meaningful differences between dexamethasone and prednisone on cognition, mood or behavior.
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Pieters R, Schulz V, Bol Schoenmakers M, van Duursen M, van den Berg M, Smit J. Activation of the AhR pathway prevents food allergy in mice. PHARMANUTRITION 2014. [DOI: 10.1016/j.phanu.2013.11.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Stojadinovic M, Pieters R, Smit J, Velickovic TC. Cross-Linking of β-Lactoglobulin Enhances Allergic Sensitization Through Changes in Cellular Uptake and Processing. Toxicol Sci 2014; 140:224-35. [DOI: 10.1093/toxsci/kfu062] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Coenen EA, Zwaan CM, Stary J, Baruchel A, de Haas V, Stam RW, Reinhardt D, Kaspers GJL, Arentsen-Peters STCJM, Meyer C, Marschalek R, Nigro LL, Dworzak M, Pieters R, van den Heuvel-Eibrink MM. Unique BHLHB3 overexpression in pediatric acute myeloid leukemia with t(6;11)(q27;q23). Leukemia 2014; 28:1564-8. [PMID: 24561520 DOI: 10.1038/leu.2014.82] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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van Dorp W, van den Heuvel-Eibrink MM, de Vries ACH, Pluijm SMF, Visser JA, Pieters R, Laven JSE. Decreased serum anti-Mullerian hormone levels in girls with newly diagnosed cancer. Hum Reprod 2013; 29:337-42. [DOI: 10.1093/humrep/det442] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Tong WH, Pieters R, Hop WCJ, van der Sluis IM. Asparagine levels in the bone marrow of patients with acute lymphoblastic leukemia during asparaginase therapy. Pediatr Blood Cancer 2013; 60:1914. [PMID: 23813969 DOI: 10.1002/pbc.24661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 05/30/2013] [Indexed: 11/07/2022]
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Furtwängler R, Gooskens SL, van Tinteren H, de Kraker J, Schleiermacher G, Bergeron C, de Camargo B, Acha T, Godzinski J, Sandstedt B, Leuschner I, Vujanic GM, Pieters R, Graf N, van den Heuvel-Eibrink MM. Clear Cell Sarcomas of the Kidney registered on International Society of Pediatric Oncology (SIOP) 93-01 and SIOP 2001 protocols: A report of the SIOP Renal Tumour Study Group. Eur J Cancer 2013; 49:3497-506. [PMID: 23880476 DOI: 10.1016/j.ejca.2013.06.036] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 06/23/2013] [Accepted: 06/26/2013] [Indexed: 01/07/2023]
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Blijdorp K, van den Heuvel-Eibrink MM, Pieters R, Pluijm SMF, Wagner A, Segers H, van der Lely AJ, Neggers SJCMM. Final height and IGF1 in adult survivors of Wilms tumour. Eur J Endocrinol 2013; 169:445-51. [PMID: 23892354 DOI: 10.1530/eje-13-0297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE One-sided nephrectomy is followed by increased levels of IGF1, associated with linear growth during childhood. The aim was to evaluate final height and IGF1 levels in nephrectomized Wilms tumour survivors when compared with healthy Dutch references and survivors of other cancer types. DESIGN Cross-sectional retrospective study. METHODS Data of 575 adult childhood cancer survivors were analysed. median follow-up time was 17.8 (range 5.048.8) years. Analysis of (co)variance was performed to evaluate differences between subgroups: nephrectomized Wilms survivors treated with or without abdominal irradiation (n=41 and n=36) and survivors of other cancer types treated with or without irradiation involving the cranium, abdomen or total body (n=149 and n=349). Main outcome measures were IGF1 and height, expressed as SDS. RESULTS After adjustment for age at diagnosis, former corticosteroid treatment and renal impairment, height SDS in non-irradiated nephrectomized Wilms survivors was significantly higher than that in non-irradiated survivors of other cancer types (estimated mean SDS -0.09 vs -0.49, P=0.044), abdominal irradiated survivors (SDS -0.70, P=0.015) and other irradiated survivors (SDS -1.47, P<0.001). Non-irradiated nephrectomized Wilms tumour survivors had significantly higher IGF1 SDS than other irradiated survivors (estimated mean SDS -0.05 vs -1.36, P<0.001 and 0.11 vs 1.37, P<0.001), while there was no significant difference with the other two subgroups. CONCLUSIONS Adult survivors of Wilms tumour showed better attainment of final height and relatively higher IGF1 levels than those of other cancer types who had significantly shorter stature and lower IGF1 levels than Dutch references.
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Ariës IM, van den Dungen ESR, Pieters R, den Boer ML. The NR4A orphan nuclear receptors do not confer prednisolone resistance in pediatric acute lymphoblastic leukemia. Leukemia 2013; 28:422-5. [PMID: 24056879 DOI: 10.1038/leu.2013.275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Segers H, van den Heuvel-Eibrink MM, Williams RD, van Tinteren H, Vujanic G, Pieters R, Pritchard-Jones K, Bown N. Gain of 1q is a marker of poor prognosis in Wilms' tumors. Genes Chromosomes Cancer 2013; 52:1065-74. [PMID: 24038759 DOI: 10.1002/gcc.22101] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 07/22/2013] [Indexed: 12/31/2022] Open
Abstract
Wilms' tumor (WT) trials aim to better tailor treatment intensity to the risk of relapse and death. Currently, stage, histology, age (< or > 24 months), and combined loss of heterozygosity at 1p and 16q in chemotherapy-naïve WTs are the only risk factors used for treatment stratification. However, they predict only less than one-third of all relapsing patients, implying that other factors are involved in treatment failure. Previous studies have associated 1q gain with adverse outcome. Therefore, in this study, the role of 1q gain and other common cytogenetic aberrations (CAs) in WTs was investigated and related to follow-up data from patients with WT treated in the United Kingdom; 19% (64/331) had 1q gain. Gain of 1q was significantly associated with 16q loss (P < 0.001) and 1p loss (P < 0.001). In multivariate analysis taking account of age, tumor stage, anaplasia, and common CA (e.g., 1p loss and 16q loss), 1q gain was independently associated with adverse event-free survival [EFS; hazard ratio (HR) = 2.45, P = 0.02] and overall survival (HR = 4.28, P = 0.004). Loss of 14q was independently associated with an adverse EFS (HR = 4.0, P = 0.04). Gain of 1q is a marker of poor prognosis in WTs, independent of high tumor stage and anaplasia which remain the overarching adverse prognostic factors. Confirmation in other studies is necessary before future therapeutic studies can incorporate 1q gain into new risk stratification schema.
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Durum SK, Li W, Zenatti P, Ribeiro D, Zuurbier L, Silva M, Paganin M, Tritapoe J, Hixon J, Silveira A, Cardoso B, Sarmento L, Correia N, Toribio M, Kobarg J, Horstmann M, Pieters R, Brandalise S, Ferrando A, Meijerink J, Yunes J, Barata J. 74. Cytokine 2013. [DOI: 10.1016/j.cyto.2013.06.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Teunis M, Vandebriel R, Woutersen R, Kegler D, Raaijmakers J, van der Valk J, Pieters R, Krul C. SLIM: A smart way from innovations to humans. Toxicol Lett 2013. [DOI: 10.1016/j.toxlet.2013.05.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Teunis MA, Spiekstra S, Smits M, Adriaens E, Eltze T, Galbiati V, Krul C, Landsiedel R, Pieters R, Reinders J, Roggen E, Corsini E, Gibbs S. An international pre-validation study on the Epidermal Equivalent sensitizer potency assay. Toxicol Lett 2013. [DOI: 10.1016/j.toxlet.2013.05.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Akbari Moqadam F, Lange-Turenhout EAM, Ariës IM, Pieters R, den Boer ML. MiR-125b, miR-100 and miR-99a co-regulate vincristine resistance in childhood acute lymphoblastic leukemia. Leuk Res 2013; 37:1315-21. [PMID: 23915977 DOI: 10.1016/j.leukres.2013.06.027] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 06/21/2013] [Accepted: 06/22/2013] [Indexed: 11/25/2022]
Abstract
MicroRNA-125b (miR-125b), miR-99a and miR-100 are overexpressed in vincristine-resistant acute lymphoblastic leukemia (ALL). Cellular viability of ETV6-RUNX1-positive Reh cells significantly increased in presence of 9 ng/mL vincristine upon co-expression of miR-125b/miR-99a (91 ± 4%), miR-125b/miR-100 (93 ± 5%) or miR-125b/miR-99a/miR-100 (82 ± 17%) compared with miR-125b-transduced cells (38 ± 13%, P<0.05). Co-expression of these miRNAs resulted in downregulation of DNTT, NUCKS1, MALAT1, SNRPE, PNO1, SET, KIF5B, PRPS2, RPS11, RPL38 and RPL23A (fold-change 1.3-1.9, p<0.05). Similarly, 7 out of these genes are lower expressed in vincristine-resistant ALL cells of children (p<0.05). The concerted function of miR-125b in combination with miR-99a and/or miR-100 illustrates the complexity of vincristine-resistant pediatric ALL.
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Smit J, Pieters R, van Roest M, Kruijssen L, Koppelman S, Opstelten DJ, Van der Kleij H. A novel peanut allergoid is safe and effective in immunotherapy in a peanut allergy mouse model. Clin Transl Allergy 2013. [PMCID: PMC3723678 DOI: 10.1186/2045-7022-3-s3-p1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Knops RRG, van Dalen EC, Mulder RL, Leclercq E, Knijnenburg SL, Kaspers GJL, Pieters R, Caron HN, Kremer LCM. The volume effect in paediatric oncology: a systematic review. Ann Oncol 2013; 24:1749-1753. [PMID: 23378538 DOI: 10.1093/annonc/mds656] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND For several adult cancer types, there is evidence that treatment in high volume hospitals, high case volume providers, or in specialised hospitals leads to a better outcome. The aim of this study is to give an overview of the existing evidence regarding the volume effect in paediatric oncology related to the quality of care or survival. MATERIALS AND METHODS An extensive search was carried out for studies on the effect of provider case volume on the quality of care or survival in childhood cancer. Information about study characteristics, comparisons, results, and quality assessment were abstracted. RESULTS In total, 14 studies were included in this systematic review. Studies with a low risk of bias provide evidence that treatment of children with brain tumours, acute lymphoblastic leukaemia, osteosarcoma, Ewing's sarcoma, or children receiving treatment with allogenic bone marrow transplantation in higher volume hospitals, specialised hospitals, or by high case volume providers, is related with a better outcome. CONCLUSIONS This systematic review provides support for the statement that higher volume hospitals, higher case volume providers, and specialised hospitals are related to the better outcome in paediatric oncology. No studies reported a negative effect of a higher volume.
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van Dorp W, Blijdorp K, Laven JSE, Pieters R, Visser JA, van der Lely AJ, Neggers SJCMM, van den Heuvel-Eibrink MM. Decreased ovarian function is associated with obesity in very long-term female survivors of childhood cancer. Eur J Endocrinol 2013; 168:905-12. [PMID: 23557987 DOI: 10.1530/eje-13-0114] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Obesity and gonadal dysfunction are known major side effects of treatment in adult childhood cancer survivors (CCS). In the general population, obesity has a negative influence on female fertility. We aimed to evaluate whether obesity and serum insulin are associated with decreased ovarian reserve markers in CCS. DESIGN Retrospective single-center cohort study. METHODS Data of 191 female survivors of childhood cancer were analyzed. Median follow-up time was 18.8 (2.348.8) years. Outcome measures were serum anti-Müllerian hormone (AMH) and total follicle count (FC). Potential risk factors were: BMI; body composition measures, determined by dual-energy X-ray absorptiometry (total fat percentage, lean body mass, and visceral fat percentage); and fasting insulin. RESULTS Lower serum AMH was found in obese subjects (β (%) -49, P=0.007) and in subjects with fasting insulin in the highest tertile (β (%) -43, P=0.039). Total fat percentage tends to be associated with serum AMH (β (%) -2.1, P=0.06). Survivors in the highest tertile of insulin had significantly lower FC than survivors in the lowest tertile (β -6.3, P=0.013). BMI and other measures of body composition were not associated with FC. Correlation between serum AMH and antral follicle count (AFC) was ρ=0.32 (P=0.08). CONCLUSIONS Obesity and insulin resistance are associated with gonadal damage, as reflected by decreased AMH and reduced FC in adult survivors of childhood cancer. In contrast to its highly predictive value for AFC in the healthy female population, serum AMH does not seem to correlate as well with AFC in CCS.
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Marshall GM, Dalla Pozza L, Sutton R, Ng A, de Groot-Kruseman HA, van der Velden VH, Venn NC, van den Berg H, de Bont ESJM, Maarten Egeler R, Hoogerbrugge PM, Kaspers GJL, Bierings MB, van der Schoot E, van Dongen J, Law T, Cross S, Mueller H, de Haas V, Haber M, Révész T, Alvaro F, Suppiah R, Norris MD, Pieters R. High-risk childhood acute lymphoblastic leukemia in first remission treated with novel intensive chemotherapy and allogeneic transplantation. Leukemia 2013; 27:1497-503. [PMID: 23407458 DOI: 10.1038/leu.2013.44] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Revised: 02/03/2013] [Accepted: 02/07/2013] [Indexed: 12/20/2022]
Abstract
Children with acute lymphoblastic leukemia (ALL) and high minimal residual disease (MRD) levels after initial chemotherapy have a poor clinical outcome. In this prospective, single arm, Phase 2 trial, 111 Dutch and Australian children aged 1-18 years with newly diagnosed, t(9;22)-negative ALL, were identified among 1041 consecutively enrolled patients as high risk (HR) based on clinical features or high MRD. The HR cohort received the AIEOP-BFM (Associazione Italiana di Ematologia ed Oncologia Pediatrica (Italy)-Berlin-Frankfurt-Münster ALL Study Group) 2000 ALL Protocol I, then three novel HR chemotherapy blocks, followed by allogeneic transplant or chemotherapy. Of the 111 HR patients, 91 began HR treatment blocks, while 79 completed the protocol. There were 3 remission failures, 12 relapses, 7 toxic deaths in remission and 10 patients who changed protocol due to toxicity or clinician/parent preference. For the 111 HR patients, 5-year event-free survival (EFS) was 66.8% (±5.5) and overall survival (OS) was 75.6% (±4.3). The 30 patients treated as HR solely on the basis of high MRD levels had a 5-year EFS of 63% (±9.4%). All patients experienced grade 3 or 4 toxicities during HR block therapy. Although cure rates were improved compared with previous studies, high treatment toxicity suggested that novel agents are needed to achieve further improvement.
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van Dorp W, van den Heuvel-Eibrink MM, Stolk L, Pieters R, Uitterlinden AG, Visser JA, Laven JSE. Genetic variation may modify ovarian reserve in female childhood cancer survivors. Hum Reprod 2013; 28:1069-76. [PMID: 23360674 DOI: 10.1093/humrep/des472] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Are genetic polymorphisms, previously identified as being associated with age at menopause in the healthy population, associated with ovarian reserve and predicted age at menopause in adult long-term survivors of childhood cancer? SUMMARY ANSWER The CT genotype of rs1172822 in the BRSK1 gene is associated with lower serum anti-Müllerian hormone (AMH) levels and a younger predicted age at menopause in adult survivors of childhood cancer. WHAT IS KNOWN ALREADY Gonadotoxicity is a well-known late side effect of chemotherapy and radiotherapy in adult survivors of childhood cancer. In the healthy population, several genetic polymorphisms are associated with age at natural menopause. Currently, data on the impact of previously identified variants in gene loci associated with ovarian reserve in adult long-term survivors of childhood cancer are lacking. STUDY DESIGN, SIZE, DURATION We performed a pilot study in a single-centre cohort of adult female Caucasian childhood cancer survivors (n = 176). PARTICIPANTS/MATERIALS, SETTING, METHODS We determined serum AMH levels (a marker of ovarian reserve) in adult survivors of childhood cancer (n = 176) and studied single nucleotide polymorphisms (SNPs) previously reported to be associated with age at natural menopause: BRSK1 (rs1172822), ARHGEF7 (rs7333181), MCM8 (rs236114), PCSK1 (rs271924), IGF2R (rs9457827) and TNF (rs909253). Association analysis was performed using the additive genetic model. Linear regression was conducted to assess the effect of significant polymorphisms in two previously published menopause prediction models. MAIN RESULTS AND THE ROLE OF CHANCE The CT genotype of rs1172822 in the BRSK1 (BR serine/threonine kinase 1) gene was negatively associated with serum AMH levels in our cohort (odds ratio: 3.15, 95% confidence interval: 1.35-7.32, P = 0.008) and significantly associated with the predicted age at menopause (P = 0.04). The other five SNPs were not associated with serum AMH levels. LIMITATIONS, REASONS FOR CAUTION This is a pilot study showing preliminary data which must be confirmed. To confirm our findings and enlarge the project, a nationwide genome-wide association (GWA) project on the ovarian reserve in female survivors of childhood cancer should be performed, including a replication cohort. WIDER IMPLICATIONS OF THE FINDINGS Our findings support the hypothesis that previously identified genetic polymorphisms associated with age at menopause in healthy women may have an effect on the onset of menopause in female survivors of childhood cancer. Our study highlights a new aspect of the influences on the ovarian reserve after childhood cancer, which should be investigated further in a nationwide GWA study. Eventually, this information can help us to improve counselling on fertility preservation prior to cancer treatment based on genetic factors in individual patients. STUDY FUNDING AND CONFLICT OF INTEREST W.D. is supported by the Paediatric Oncology Centre Society for Research (KOCR), Rotterdam, The Netherlands. J.S.E.L. has received fees and grant support from the following companies (in alphabetic order): Ferring, Genovum, Merck-Serono, Organon, Schering Plough and Serono. All other authors have nothing to disclose.
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Quinn LP, Roos C, Pieters R, Løken K, Polder A, Skaare JU, Bouwman H. Levels of PCBs in wild bird eggs: considering toxicity through enzyme induction potential and molecular structure. CHEMOSPHERE 2013; 90:1109-1116. [PMID: 23062940 DOI: 10.1016/j.chemosphere.2012.09.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 07/15/2012] [Accepted: 09/08/2012] [Indexed: 06/01/2023]
Abstract
Polychlorinated biphenyls (PCBs) were analysed in wild bird eggs from industrialised areas in South Africa. The concentration, congener profile, feeding guild, potential associated risk and biology were investigated. PCBs were detected in all eggs with 30 congeners present in more than 80% of the samples. Σ(34)PCB concentrations ranged between 0.9 and 296 ng g(-1) wet weight (ww). The metabolic potential of the PCB metabolic groups showed good agreement with the biodegradability of the individual congeners. Phenobarbital-type (PB-type) inducer PCBs were prevalent, indicating the predominance of less toxic PCB congeners. However, non-ortho PCBs which were not included in the current analyses, could affect the toxic potential of the PCBs in the eggs requiring more investigation. Although the current levels of PCBs measured do not indicate a health risk to the birds assessed, the presence of mono-ortho PCBs at appreciable levels motivates for the assessment of dioxin-like chemicals in wild bird eggs.
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