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Felix A, Dichamp C, Michaux K, Minard-Colin V, Sarnacki S, Lacour B, Valteau-Couanet D. Afro-descendant ethnicity does not negatively influence neuroblastoma survival in the French West Indies. Pediatr Blood Cancer 2024; 71:e31037. [PMID: 38745371 DOI: 10.1002/pbc.31037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Arthur Felix
- Department of Pediatrics, Children Hematology and Oncology Unit, University Hospital of Fort-de France, Martinique, France
- EpiCliV Research Unit, University of the French West Indies, Martinique University Hospital, Fort-de France, France
| | - Claire Dichamp
- Department of Pediatrics, Children Hematology and Oncology Unit, University Hospital of Fort-de France, Martinique, France
| | - Katell Michaux
- Department of Pediatrics, Children Hematology and Oncology Unit, University Hospital of Fort-de France, Martinique, France
| | - Véronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy, Université Paris-Saclay, Villejuif, France
| | - Sabine Sarnacki
- Department of Pediatric Surgery, Hôpital Necker Enfants Malades-Université de Paris Cité, Paris, France
| | - Brigitte Lacour
- French National Registry of Childhood Cancer, National Registry of Childhood Solid Tumors, CHRU Nancy, Vandoeuvre-les-Nancy, France
| | - Dominique Valteau-Couanet
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy, Université Paris-Saclay, Villejuif, France
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2
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Ruiz J, Li Y, Cao L, Huang YSV, Tam V, Griffis HM, Winestone LE, Fisher BT, Alonzo TA, Wang YCJ, Dang AT, Kolb EA, Glanz K, Getz KD, Aplenc R, Seif AE. Association of the social disorganization index with time to first septic shock event in children with acute myeloid leukemia. Cancer 2024; 130:962-972. [PMID: 37985388 PMCID: PMC10922804 DOI: 10.1002/cncr.35109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/19/2023] [Accepted: 10/09/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Pediatric acute myeloid leukemia (AML) chemotherapy increases the risk of life-threatening complications, including septic shock (SS). An area-based measure of social determinants of health, the social disorganization index (SDI), was hypothesized to be associated with SS and SS-associated death (SS-death). METHODS Children treated for de novo AML on two Children's Oncology Group trials at institutions contributing to the Pediatric Health Information System (PHIS) database were included. The SDI was calculated via residential zip code data from the US Census Bureau. SS was identified via PHIS resource utilization codes. SS-death was defined as death within 2 weeks of an antecedent SS event. Patients were followed from 7 days after the start of chemotherapy until the first of end of front-line therapy, death, relapse, or removal from study. Multivariable-adjusted Cox regressions estimated hazard ratios (HRs) comparing time to first SS by SDI group. RESULTS The assembled cohort included 700 patients, with 207 (29.6%) sustaining at least one SS event. There were 233 (33%) in the SDI-5 group (highest disorganization). Adjusted time to incident SS did not statistically significantly differ by SDI (reference, SDI-1; SDI-2: HR, 0.84 [95% confidence interval (CI), 0.51-1.41]; SDI-3: HR, 0.70 [95% CI, 0.42-1.16]; SDI-4: HR, 0.97 [95% CI, 0.61-1.53]; SDI-5: HR, 0.72 [95% CI, 0.45-1.14]). Nine patients (4.4%) with SS experienced SS-death; seven of these patients (78%) were in SDI-4 or SDI-5. CONCLUSIONS In a large, nationally representative cohort of trial-enrolled pediatric patients with AML, there was no significant association between the SDI and time to SS.
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Affiliation(s)
- Jenny Ruiz
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yimei Li
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lusha Cao
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Yuan-Shung V Huang
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Vicky Tam
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Heather M Griffis
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lena E Winestone
- Division of Allergy, Immunology, and Bone Marrow Transplantation, Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
| | - Brian T Fisher
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Todd A Alonzo
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | | | - Alice T Dang
- Public Health Institute, Monrovia, California, USA
| | - E Anders Kolb
- Nemours Center for Cancer and Blood Disorders, Nemours Children's Health, Wilmington, Delaware, USA
| | - Karen Glanz
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kelly D Getz
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Richard Aplenc
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alix E Seif
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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3
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Castellanos MI, Oluyomi AO, Chambers TM, Gramatges MM, Winestone LE, Lupo PJ, Scheurer ME. Ethnic disparities in childhood leukemia survival by border residence: A Texas population-based analysis. Cancer 2023; 129:1276-1286. [PMID: 36805949 DOI: 10.1002/cncr.34636] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 02/23/2023]
Abstract
BACKGROUND The US-Mexico border is a medically underserved region where survival disparities have been observed in adults diagnosed and treated for various malignancies. Studies examining survival disparities among children living in this region and diagnosed with cancer are lacking. The objective of this study was to evaluate the impact of border residence on survival among children with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and living near the Texas-Mexico border at the time of their diagnosis. The authors hypothesized that this group experiences inferior survival compared with patients with childhood leukemia living in nonborder areas. METHODS The authors conducted a retrospective survival analysis leveraging data from the Texas Cancer Registry. The study included patients aged birth to 19 years who were diagnosed with ALL or AML between 1995 and 2017. Cox proportional hazards models were used to evaluate the factors associated with the risk of death. Overall survival estimates were calculated using Kaplan-Meier methods. RESULTS During the study period, there were 6002 children diagnosed with ALL and 1279 diagnosed with AML. Inferior 5-year overall survival was observed among children with ALL living along the border region compared with those living in nonborder areas (77.5% vs. 85.8%). In adjusted models, children with ALL living along the border experienced a 30% increased hazard of death versus children living in nonborder areas. In contrast, for children with AML, survival estimates did not vary by border versus nonborder residence. CONCLUSIONS Living along the border was associated with inferior survival among children with ALL, but not among children with AML. Additional studies are urgently needed to identify the factors driving these disparities to effectively design multilevel interventions and influence state and national cancer control programs.
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Affiliation(s)
- Maria I Castellanos
- Section of Hematology/Oncology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Abiodun O Oluyomi
- Department of Medicine, Epidemiology, and Population Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Tiffany M Chambers
- Section of Hematology/Oncology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Maria M Gramatges
- Section of Hematology/Oncology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Lena E Winestone
- Division of Allergy, Immunology, and Blood and Marrow Transplant, University of California-San Francisco Benioff Children's Hospitals, San Francisco, California, USA
| | - Philip J Lupo
- Section of Hematology/Oncology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Michael E Scheurer
- Section of Hematology/Oncology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
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Akande M, Paquette ET, Magee P, Perry-Eaddy MA, Fink EL, Slain KN. Screening for Social Determinants of Health in the Pediatric Intensive Care Unit: Recommendations for Clinicians. Crit Care Clin 2023; 39:341-355. [PMID: 36898778 PMCID: PMC10332174 DOI: 10.1016/j.ccc.2022.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Social determinants of health (SDoH) play a significant role in the health and well-being of children in the United States. Disparities in the risk and outcomes of critical illness have been extensively documented but are yet to be fully explored through the lens of SDoH. In this review, we provide justification for routine SDoH screening as a critical first step toward understanding the causes of, and effectively addressing health disparities affecting critically ill children. Second, we summarize important aspects of SDoH screening that need to be considered before implementing this practice in the pediatric critical care setting.
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Affiliation(s)
- Manzilat Akande
- Section of Critical Care, Department of Pediatrics, Oklahoma University Health Sciences Center, OU Children's Physicians Building, 1200 Children's Avenue, Oklahoma City, OK 73104, USA.
| | - Erin T Paquette
- Division of Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East, Chicago Avenue, Box 73, Chicago, IL 60611, USA
| | - Paula Magee
- Division of Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East, Chicago Avenue, Box 73, Chicago, IL 60611, USA
| | - Mallory A Perry-Eaddy
- University of Connecticut School of Nursing, 231 Glenbrook Rd, U-4026, Storrs, CT 06269, USA; Department of Pediatrics, University of Connecticut School of Medicine, 200 Academic Way, Farmington, CT 06032, USA
| | - Ericka L Fink
- Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Faculty Pavilion, 2nd floor, Pittsburgh, PA 15206, USA
| | - Katherine N Slain
- Division of Pediatric Critical Care Medicine, University Hospitals Rainbow Babies & Children's Hospital, 11100 Euclid Avenue, RBC 6010 Cleveland, OH 44106, USA; Department of Pediatrics, Case Western Reserve University School of Medicine, 9501 Euclid Avenue, Cleveland, OH 44106, USA
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5
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Elshanbary AA, Zilai AH, Ishqair A, Matar SG, Nourelden AZ, Hafez AH, Altyar AE, Albadrani GM, Zaazouee MS. Demographic and treatment risk factors of cancer-specific mortality among children and adolescent leukemia patients: a population-based study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:19182-19193. [PMID: 36220963 DOI: 10.1007/s11356-022-23425-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Leukemia is the 15th most commonly diagnosed cancer and the 11th leading cause of cancer mortality. The high mortality rate of leukemia could be attributed to numerous factors. Therefore, we aimed to identify the demographic and treatment risk factors influencing mortality among patients diagnosed with leukemia. Patients' data from 1975 to 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. We used the Person's chi-square test to examine the associations among the categorical variables. Kaplan-Meier and Cox regression were applied for univariate and multivariate analyses. Standardized mortality ratios were utilized to compare the mortality rates of leukemia patients and the general US population. We carried out the statistical analysis using SPSS software. A total of 18,880 patients with leukemia were studied. The leukemia incidence was increased in children than in adolescents. Acute lymphoid leukemia (ALL) was the most common type diagnosed among children and adolescents: 10,331 and 4112 patients, respectively. All mortality ratios were significantly higher in leukemia patients compared to the US population. The risk of mortality among leukemia patients was higher among adolescents, females, Black, urban areas with a 20,000 population, and patients not receiving chemotherapy. In contrast, the mortality risk was decreased in patients with higher family incomes, those not treated with radiation, and diagnosed from 2000 to 2016. In conclusion, Leukemia's incidence increases with time. Adolescents, males, Black, in some urban areas, and patients who have not received chemotherapy had the highest mortality risk among leukemia patients.
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Affiliation(s)
| | - Ayat Hassan Zilai
- Department of Pediatrics, King Salman Hospital, Riyadh, Saudi Arabia
| | - Anas Ishqair
- Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | | | | | | | - Ahmed E Altyar
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Ghadeer M Albadrani
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
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Wang Y, Ma X, Huang J, Yang X, Kang M, Sun X, Li H, Wu Y, Zhang H, Zhu Y, Xue Y, Fang Y. Somatic FOXC1 insertion mutation remodels the immune microenvironment and promotes the progression of childhood acute lymphoblastic leukemia. Cell Death Dis 2022; 13:431. [PMID: 35504885 PMCID: PMC9065155 DOI: 10.1038/s41419-022-04873-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 04/10/2022] [Accepted: 04/20/2022] [Indexed: 12/14/2022]
Abstract
Acute lymphoblastic leukemia (ALL) is the most common malignant hematological diseases in children. An immunosuppressive microenvironment, particularly regulatory T cell (Treg) infiltration, has been documented to be highly associated with childhood ALL. This present study, based on genetic factors, was aimed at investigating the mutations potentially involved in the immunosuppressive microenvironment in childhood ALL. After whole-exome sequencing was used on DNA extracted from the T cells of ALL bone marrow samples, we found the FOXC1 H446HG induced a increased Treg while decreased cytotoxic T lymphocyte (CTL) in bone marrow. The mutation of FOXC1 in T cell promoted the proliferation of leukemia cells in vitro and in vivo. CpG islands formed by insertion mutation led to an abnormal increase in exon methylation and were associated with the suppression of FOXC1. Decreased FOXC1 attenuated the transcription of HDAC1, thus resulting in the activation of KLF10 through increasing H3K27 acetylation in the promoter region. In conclusion, the de novo insertion mutation in FOXC1 induced suppression of FOXC1, thereby promoting a Treg/CTL shift in the ALL immune microenvironment. The FOXC1 H446HG mutation might be a potential therapeutic target for ALL in the future.
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Affiliation(s)
- Yaping Wang
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Xiaopeng Ma
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Jie Huang
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Xiaoyun Yang
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Meiyun Kang
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Xiaoyan Sun
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Huimin Li
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Yijun Wu
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Heng Zhang
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Yuting Zhu
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Yao Xue
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
| | - Yongjun Fang
- grid.89957.3a0000 0000 9255 8984Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing Medical University, 72# Guangzhou Road, Nanjing, Jiangsu Province China
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