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O'Neill AF, Towbin AJ, Krailo MD, Xia C, Gao Y, McCarville MB, Meyers RL, McGahren ED, Tiao GM, Dunn SP, Langham MR, Weldon CB, Finegold MJ, Ranganathan S, Furman WL, Malogolowkin M, Rodriguez-Galindo C, Katzenstein HM. Characterization of Pulmonary Metastases in Children With Hepatoblastoma Treated on Children's Oncology Group Protocol AHEP0731 (The Treatment of Children With All Stages of Hepatoblastoma): A Report From the Children's Oncology Group. J Clin Oncol 2017; 35:3465-3473. [PMID: 28892430 DOI: 10.1200/jco.2017.73.5654] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose To determine whether the pattern of lung nodules in children with metastatic hepatoblastoma (HB) correlates with outcome. Methods Thirty-two patients with metastatic HB were enrolled on Children's Oncology Group Protocol AHEP0731 and treated with vincristine and irinotecan (VI). Responders to VI received two additional cycles of VI intermixed with six cycles of cisplatin/fluorouracil/vincristine/doxorubicin (C5VD), and nonresponders received six cycles of C5VD alone. Patients were imaged after every two cycles and at the conclusion of therapy. All computed tomography scans and pathology reports were centrally reviewed, and information was collected regarding lung nodule number, size, laterality, timing of resolution, and pulmonary surgery. Results Among the 29 evaluable patients, only 31% met Response Evaluation Criteria in Solid Tumors (RECIST) for measurable metastatic disease. The presence of measurable disease by RECIST, the sum of nodule diameters greater than or equal to the cumulative cohort median size, bilateral disease, and ≥ 10 nodules were each associated with an increased risk for an event-free survival event ( P = .48, P = .08, P = .065, P = .03, respectively), with nodule number meeting statistical significance. Ten patients underwent pulmonary resection/metastasectomy at various time points, the benefit of which could not be determined because of small patient numbers. Conclusion Children with metastatic HB have a poor prognosis. Overall tumor burden may be an important prognostic factor for these patients. Lesions that fail to meet RECIST size criteria (ie, those < 10 mm) at diagnosis may contain viable tumor, whereas residual lesions at the end of therapy may constitute eradicated tumor/scar tissue. Patients may benefit from risk stratification on the basis of the burden of lung metastatic disease at diagnosis.
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Affiliation(s)
- Allison F O'Neill
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Alexander J Towbin
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Mark D Krailo
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Caihong Xia
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Yun Gao
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - M Beth McCarville
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Rebecka L Meyers
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Eugene D McGahren
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Greg M Tiao
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Stephen P Dunn
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Max R Langham
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Christopher B Weldon
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Milton J Finegold
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Sarangarajan Ranganathan
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Wayne L Furman
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Marcio Malogolowkin
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Carlos Rodriguez-Galindo
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
| | - Howard M Katzenstein
- Allison F. O'Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children's Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children's Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L. Furman, and Carlos Rodriguez-Galindo, St Jude Children's Research Hospital; Max R. Langham Jr, Le Bonheur Children's Hospital and University of Tennessee, Memphis; Howard M. Katzenstein, Vanderbilt University School of Medicine, Monroe Carell Jr Children's Hospital, Nashville, TN; Rebecka L. Meyers, Primary Children's Hospital and University of Utah, Salt Lake City, UT; Eugene D. McGahren, University of Virginia Children's Hospital and University of Virginia, Charlottesville, VA; Stephen P. Dunn, duPont Hospital for Children and Thomas Jefferson University, Philadelphia; Sarangarajan Ranganathan, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; and Milton J. Finegold, Baylor College of Medicine, Houston, TX
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