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Mandrell BN, Blake AK, Sharp KMH, Gattuso JS, McGee RB, Harrison L, Ouma A, Caples M, Johnson LM, Nichols KE. Parental Understanding of Their Child's Germline Genomic Testing: Intent of Disclosure to Their Child and Family. J Pers Med 2023; 13:1656. [PMID: 38138883 PMCID: PMC10744428 DOI: 10.3390/jpm13121656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 12/24/2023] Open
Abstract
Genomic testing is becoming increasingly common in the care of pediatric patients with cancer. Parental understanding of germline results and their intent and timing of results disclosure to their child and family may have significant implications on the family unit. The purpose of this study was to examine parental understanding of germline genomic results and plans for disclosure to their child and other relatives. Semi-structured interviews were conducted with 64 parents of children with cancer, approximately eight weeks after parents had received their child's results. Parents of children with negative results (n = 20), positive results (n = 15), or variants of uncertain significance (n = 29), were interviewed. Fifty-three parents (83%) correctly identified their child's results as negative, uncertain, or positive. Most parents had disclosed results to family members; however, only 11 parents (17%) acknowledged discussing results with their child. Most parents delayed disclosure due to the young age of their child at the time of testing. In summary, most parents appropriately described their child's germline genomic results, yet few discussed the results with their child due to age. Families should be followed with supportive counseling to assist parents in the timing and content of result disclosure to their children.
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Affiliation(s)
- Belinda N. Mandrell
- Division of Nursing Research, Department of Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (J.S.G.); (M.C.)
| | - Alise K. Blake
- Division of Cancer Predisposition, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (A.K.B.); (R.B.M.); (L.H.); (A.O.); (K.E.N.)
| | | | - Jami S. Gattuso
- Division of Nursing Research, Department of Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (J.S.G.); (M.C.)
| | - Rose B. McGee
- Division of Cancer Predisposition, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (A.K.B.); (R.B.M.); (L.H.); (A.O.); (K.E.N.)
| | - Lynn Harrison
- Division of Cancer Predisposition, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (A.K.B.); (R.B.M.); (L.H.); (A.O.); (K.E.N.)
| | - Annastasia Ouma
- Division of Cancer Predisposition, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (A.K.B.); (R.B.M.); (L.H.); (A.O.); (K.E.N.)
| | - Mary Caples
- Division of Nursing Research, Department of Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (J.S.G.); (M.C.)
| | - Liza-Marie Johnson
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA;
| | - Kim E. Nichols
- Division of Cancer Predisposition, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (A.K.B.); (R.B.M.); (L.H.); (A.O.); (K.E.N.)
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Sharma A, Young A, Carroll Y, Darji H, Li Y, Mandrell BN, Nelson MN, Owens CL, Irvine M, Caples M, Jerkins LP, Unguru Y, Hankins JS, Johnson LM. Gene therapy in sickle cell disease: Attitudes and informational needs of patients and caregivers. Pediatr Blood Cancer 2023; 70:e30319. [PMID: 36975201 PMCID: PMC10187715 DOI: 10.1002/pbc.30319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/23/2023] [Accepted: 03/05/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is an inherited blood disorder that results in serious morbidity and early mortality. Novel therapies for SCD, most notably genetic therapies (GTs) and HLA-mismatched donor hematopoietic cell transplantation, are in clinical trials. While potentially curative, these interventions are some of the most intensive treatments for SCD and are associated with serious and life-altering side effects, which may manifest several years after treatment. Little is known about knowledge, beliefs, and attitudes of individuals with SCD, or their caregivers, toward existing and these emerging therapies. METHODS Patients with SCD at least 13 years of age (n = 66) and caregivers (n = 38) were surveyed about knowledge, attitudes, and beliefs surrounding treatments for SCD. RESULTS Only 4.8% felt "extremely knowledgeable" about GT for SCD while the majority (63.4%) reported little knowledge. Overall, health literacy was low among respondents. Most respondents had a neutral attitude regarding the safety of GT for SCD, and whether it was a good treatment for the disorder (56.7% and 58.6%, respectively). Only a few respondents endorsed the idea that GT was "unsafe" or "not a good treatment" (5.8% and 4.8%, respectively). There was an association between increasing knowledge about GT and agreement that it is safe (p = .012) and a good treatment for SCD (p = .031). CONCLUSIONS Given that very few patients with SCD feel knowledgeable about GT and a majority have neutral feelings about the safety and utility of this new approach, culturally appropriate patient-centered education is urgently needed as these treatments get regulatory approval and proceed to the clinic.
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Affiliation(s)
- Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Amanda Young
- Department of Communication and Film, University of Memphis, Memphis, Tennessee, USA
| | - Yvonne Carroll
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Himani Darji
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Yimei Li
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Belinda N Mandrell
- Division of Nursing Research, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Marquita N Nelson
- Division of Hematology/Oncology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Curtis L Owens
- Division of Hematology/Oncology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Mary Irvine
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Mary Caples
- Division of Nursing Research, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Lauren P Jerkins
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Yoram Unguru
- Division of Pediatric Hematology/Oncology, The Herman and Walter Samuelson Children's Hospital at Sinai, Baltimore, Maryland, USA
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jane S Hankins
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Liza-Marie Johnson
- Departmet of Oncology and Hematology/Oncology Hospitalist Medicine Program, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Mandrell BN, Johnson LM, Caples M, Gattuso J, Maciaszek JL, Mostafavi R, Sharp KMH, Nichols KE. Parental Preferences Surrounding Timing and Content of Consent Conversations for Clinical Germline Genetic Testing Following a Child's New Cancer Diagnosis. JCO Precis Oncol 2022; 6:e2200323. [PMID: 36265116 PMCID: PMC9848596 DOI: 10.1200/po.22.00323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/10/2022] [Accepted: 08/30/2022] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Clinical genomic testing is increasingly being used to direct pediatric cancer care. Many centers are interested in offering testing of tumors and paired germline tissues at or near the time of cancer diagnosis. We conducted this study to better understand parent preferences surrounding timing and content of consent conversations for clinical germline genetic testing of their children with cancer as a part of real-time cancer care. PATIENTS AND METHODS A seven-question survey developed by the Division of Cancer Predisposition and collaborators at St Jude Children's Research Hospital (St Jude) was distributed to members of the St Jude Patient Family Advisory Council, which included parents of childhood cancer survivors and bereaved parents whose children with cancer had died. Parents were asked to provide free text comments after each question. Qualitative methods were used to derive codes from parent comments, and survey results were depicted using descriptive statistics. RESULTS The survey was completed by 172 parents. Ninety-three (54%) endorsed an approach for consent conversations ≥ 1 month after cancer diagnosis, whereas 58 (34%) endorsed an approach at 1-2 weeks and 21 (12%) at 1-2 days. Needing time to adjust to a new or relapsed cancer diagnosis and feeling overwhelmed were frequent themes; however, parents acknowledged the urgency and importance of testing. Parents desired testing of as many cancer-related genes as possible, with clinical utility the most important factor for proceeding with testing. Most parents (75%) desired germline results to be disclosed in person, preferably by a genetic counselor. CONCLUSION Parents described urgency and benefits associated with germline testing, but desired flexibility in timing to allow for initial adjustment after their child's cancer diagnosis.
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Affiliation(s)
- Belinda N. Mandrell
- Division of Nursing Research, Department of Pediatrics, St Jude Children's Research Hospital, Memphis, TN
| | - Liza Marie Johnson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Mary Caples
- Division of Nursing Research, Department of Pediatrics, St Jude Children's Research Hospital, Memphis, TN
| | - Jami Gattuso
- Division of Nursing Research, Department of Pediatrics, St Jude Children's Research Hospital, Memphis, TN
| | - Jamie L. Maciaszek
- Department of Pathology, St Jude Children's Research Hospital, Memphis, TN
| | - Roya Mostafavi
- Division of Cancer Predisposition, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | | | - Kim E. Nichols
- Division of Cancer Predisposition, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
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Mandrell BN, Gattuso JS, Pritchard M, Caples M, Howard Sharp KM, Harrison L, Ouma AA, Valdez JM, Johnson LM, Nichols KE. Knowledge Is Power: Benefits, Risks, Hopes, and Decision-Making Reported by Parents Consenting to Next-Generation Sequencing for Children and Adolescents with Cancer. Semin Oncol Nurs 2021; 37:151167. [PMID: 34127338 DOI: 10.1016/j.soncn.2021.151167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To qualitatively describe parent perspectives of next-generation genomic sequencing (NGS) for their children with cancer, including perceived benefits, risks, hopes/expectations, and decision-making process when consenting or not consenting to NGS and prior to result disclosure. DATA SOURCES Qualitative interviews were used. CONCLUSION Altruism is an important factor in parents consenting to NGS testing, as well as making sense of their child's cancer and legacy building. Parents described realistic hopes and expectations associated with NGS participation. Although parents endorsed the likelihood of no medical benefit, those consenting to NGS felt there was no reason not to participate. Parents declining participation expressed avoidance of worry and parent guilt if a germline variant were to be disclosed. IMPLICATIONS FOR NURSING PRACTICE As NGS evolves into a component of the routine diagnostic workup for pediatric cancer patients, genetic nurses play a role in conducting informed consent conversations and ensuring that patients and families have realistic hopes and expectations associated with NGS.
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Affiliation(s)
- Belinda N Mandrell
- Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children's Research Hospital, Memphis, TN.
| | - Jami S Gattuso
- Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children's Research Hospital, Memphis, TN
| | - Michele Pritchard
- Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children's Research Hospital, Memphis, TN
| | - Mary Caples
- Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children's Research Hospital, Memphis, TN
| | | | - Lynn Harrison
- Department of Oncology, Division Cancer Predisposition, St. Jude Children's Research Hospital, Memphis, TN
| | - Annastasia A Ouma
- Department of Oncology, Division Cancer Predisposition, St. Jude Children's Research Hospital, Memphis, TN
| | - Jessica M Valdez
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN; Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque
| | - Liza-Marie Johnson
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, Memphis, TN
| | - Kim E Nichols
- Department of Oncology, Division Cancer Predisposition, St. Jude Children's Research Hospital, Memphis, TN
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Walsh S, O'Mahony M, Lehane E, Farrell D, Taggart L, Kelly L, Sahm L, Byrne A, Corrigan M, Caples M, Martin AM, Tabirca S, Corrigan MA, Hegarty J. Cancer and breast cancer awareness interventions in an intellectual disability context: A review of the literature. J Intellect Disabil 2021; 25:131-145. [PMID: 31104540 DOI: 10.1177/1744629519850999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Women with an intellectual disability (ID) have a similar risk of developing breast cancer as women in the general population yet present with later stage breast cancers, which have poorer outcomes. AIM To identify whether there is a need to develop a breast cancer awareness intervention for women with an ID. METHODS Interventions aimed at increasing cancer awareness and breast cancer awareness for people with an ID were identified and critically appraised. RESULTS Five interventions to increase cancer awareness or breast cancer awareness in people with an ID were identified. CONCLUSION The review highlighted the paucity of theoretically underpinned breast cancer awareness interventions specifically aimed at women with an ID. Facilitating breast cancer awareness for women with an ID could potentially lead to earlier presentation of potential symptoms of breast cancer, earlier treatment, better prognosis and ultimately, improved survival. This article establishes that there is a need for an intervention underpinned by theory to increase breast cancer awareness in women with an ID.
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Affiliation(s)
- S Walsh
- 8795University College Cork, Ireland
| | | | - E Lehane
- 8795University College Cork, Ireland
| | - D Farrell
- 8813Institute of Technology Tralee, Ireland
| | - L Taggart
- 2596Ulster University, Northern Ireland
| | - L Kelly
- 57983Cork Breast Research Centre-Cork University Hospital, Ireland
| | - L Sahm
- 8795University College Cork, Ireland
| | - A Byrne
- 63976Cope Foundation, Ireland
| | - M Corrigan
- St. John of God Hospitaller Ministries, Ireland
| | - M Caples
- 8795University College Cork, Ireland
| | | | - S Tabirca
- 8795University College Cork, Ireland
| | - M A Corrigan
- 57983Cork Breast Research Centre-Cork University Hospital, Ireland
| | - J Hegarty
- 8795University College Cork, Ireland
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Niel K, LaRosa KN, Klages KL, Merchant TE, Wise MS, Witcraft SM, Hancock D, Caples M, Mandrell BN, Crabtree VM. Actigraphy versus Polysomnography to Measure Sleep in Youth Treated for Craniopharyngioma. Behav Sleep Med 2020; 18:589-597. [PMID: 31303059 DOI: 10.1080/15402002.2019.1635133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE/BACKGROUND Youth with craniopharyngioma are at increased risk for excessive daytime sleepiness and narcolepsy. Polysomnography (PSG) is the gold standard for diagnosing sleep disorders, but is time-intensive, costly, and does not offer an in vivo measure of typical sleep routine. We determined the sensitivity, specificity, and accuracy of actigraphy compared with PSG in measuring nocturnal sleep in pediatric craniopharyngioma. PARTICIPANTS Fifty youth with craniopharyngioma (age 3-20 years) were assessed by overnight PSG and concurrent actigraphy after surgical resection and before proton therapy. METHODS PSG and actigraphy data were synchronized utilizing an epoch-by-epoch comparison method. Sensitivity, specificity, and accuracy were calculated using measures of true wake, true sleep, false wake, and false sleep. Bland-Altman plots were conducted to further assess level of agreement. RESULTS Actigraphy was 93% sensitive (true sleep [TS]) and 87% accurate (ability to detect TS and true wake) in measuring sleep versus wakefulness and was a reliable measure of sleep efficiency (SE) and sleep latency (SL). Specificity (true wake) was poor (55%) and total sleep time (TST) was underestimated by an average of 15.1 min. Wake after sleep onset (WASO) was overestimated by an average of 14.7 min. CONCLUSIONS Actigraphy was highly sensitive and accurate and was a reliable measure of SE and SL. Although there were differences in TST and WASO measurements by actigraphy and PSG, our findings provide the basis for future studies on the use of actigraphy to monitor treatment response to wakefulness-promoting medications in youth with craniopharyngioma who demonstrate excessive daytime sleepiness.
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Affiliation(s)
- Kristin Niel
- Department of Psychology, St. Jude Children's Research Hospital , Memphis, TN
| | - Kayla N LaRosa
- Department of Psychology, St. Jude Children's Research Hospital , Memphis, TN
| | | | - Thomas E Merchant
- Department of Radiation Oncology, St. Jude Children's Research Hospital , Memphis, TN
| | - Merrill S Wise
- Department of Sleep Disorders, Methodist Healthcare Sleep Disorders Center , Memphis, TN
| | - Sara M Witcraft
- Department of Psychology, The University of Mississippi , MS
| | - Donna Hancock
- Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children's Research Hospital , Memphis, TN
| | - Mary Caples
- Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children's Research Hospital , Memphis, TN
| | - Belinda N Mandrell
- Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children's Research Hospital , Memphis, TN
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LaRosa KN, Crowley SJ, Hancock D, Caples M, Merchant TE, Crabtree VM, Mandrell B. 0994 Assessment Of Sleep-wake And Circadian Rhythm Disruption In Children And Adolescents Diagnosed With Craniopharyngioma. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Patients with craniopharyngioma are at increased risk for hypersomnia/narcolepsy and circadian rhythm disruption, secondary to hypothalamic-pituitary involvement of the tumor. We assessed youth with craniopharyngioma to determine presence of the dim light melatonin onset (DLMO) and concurrent sleep disturbance.
Methods
Fifty-two patients (7-21 years; 51% female) enrolled on our institutional protocol for craniopharyngioma that included surgery, proton therapy, or both. In-home salivary melatonin was collected after surgery and hourly beginning 3 h before to 1 h after habitual bedtime to determine the DLMO, which was defined as the time that melatonin exceeded a 4 pg/mL threshold. Polysomnography and a next day multiple sleep latency test (MSLT) were also conducted.
Results
Hypersomnia/narcolepsy was indicated in 86% of patients. DLMO was detected in 29 (56%) patients and averaged 21:04 (±1:14). All but 2 patients with a DLMO had a concurrent sleep diagnosis (18 hypersomnia, 8 narcolepsy, 1 insomnia). In those we could not compute a DLMO, melatonin was above the 4 pg/mL threshold in 19 (37%), suggesting that the DLMO was likely earlier than the sampling window. Two (4%) did not reach threshold, suggesting that the DLMO was later than the window. For patients in which DLMO was not computed, all but 4 had a concurrent sleep diagnosis (7 hypersomnia, 9 narcolepsy, 1 MSLT not completed). Three (6%) participants showed a pattern of melatonin decreasing before bedtime (2 hypersomnia, 1 narcolepsy). Sleep disorder diagnosis was not associated with whether a DLMO was detected or not.
Conclusion
DLMO did not occur within the sampling window in 44% of patients with the majority due to the DLMO likely occurring before sampling started. Simultaneous assessment of both sleep-wake disturbance and circadian phase could provide more informed sleep interventions for excessive sleepiness and circadian misalignment in this patient population.
Support
This study was supported by cancer center grant (CA21765) from the National Cancer Institute, and ALSAC.
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Affiliation(s)
- K N LaRosa
- St. Jude Children’s Research Hospital, Memphis, TN
| | | | - D Hancock
- St. Jude Children’s Research Hospital, Memphis, TN
| | - M Caples
- St. Jude Children’s Research Hospital, Memphis, TN
| | - T E Merchant
- St. Jude Children’s Research Hospital, Memphis, TN
| | - V M Crabtree
- St. Jude Children’s Research Hospital, Memphis, TN
| | - B Mandrell
- St. Jude Children’s Research Hospital, Memphis, TN
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Mandrell BN, LaRosa K, Hancock D, Caples M, Sykes A, Lu Z, Wise MS, Khan RB, Merchant TE, McLaughlin-Crabtree V. Predictors of narcolepsy and hypersomnia due to medical disorder in pediatric craniopharyngioma. J Neurooncol 2020; 148:307-316. [DOI: 10.1007/s11060-020-03519-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/23/2020] [Indexed: 01/17/2023]
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LaRosa KN, Crabtree V, Sykes A, Lu Z, Merchant TE, Wise MS, Hancock D, Caples M, Mandrell B. 0817 Predictors of Hypersomnia and Narcolepsy in Pediatric Craniopharyngioma. Sleep 2019. [DOI: 10.1093/sleep/zsz067.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - April Sykes
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Zhaohua Lu
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | | | - Donna Hancock
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Mary Caples
- St. Jude Children's Research Hospital, Memphis, TN, USA
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LaRosa KN, Niel K, Klages KL, Merchant TE, Wise MS, Witcraft S, Hancock D, Caples M, Mandrell B, Crabtree VM. 0808 Comparison of Actigraphy to Polysomnography in the Measurement of Nocturnal Sleep in Children with Craniopharyngioma. Sleep 2019. [DOI: 10.1093/sleep/zsz067.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kayla N LaRosa
- Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kristin Niel
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | | | | | - Donna Hancock
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Mary Caples
- St. Jude Children's Research Hospital, Memphis, TN, USA
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Klages K, Mandrell B, Wise M, Merchant T, Hancock D, Caples M, Crabtree V. 0807 Health-Related Quality of Life, Obesity, Disrupted Sleep, and Psychosocial Problems Among Youth With Craniopharyngioma. Sleep 2019. [DOI: 10.1093/sleep/zsz067.805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kimberly Klages
- Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Merrill Wise
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Donna Hancock
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Mary Caples
- St. Jude Children's Research Hospital, Memphis, TN, USA
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Walsh S, Lehane E, Hegarty J, O’mahony M, Farrell D, Taggart L, Kelly L, Sahm L, Byrne A, Corrigan M, Caples M, Martin A, Tabirca S, Corrigan M. Breast awareness amongst women with a mild/moderate intellectual disability: Linking theory to practice. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Twenty-five transfusion-dependent myelodysplastic syndrome (MDS) patients (with < 20% blasts) were treated in a phase II study with antithymocyte globulin (ATG) at 40 mg/kg/d for four doses and then followed with blood counts every 2 weeks and clinic visits every 3 months, for a median of 14 months (range 1-38 months). 11 (44%) patients responded and became transfusion-independent after ATG, including three complete responses, six partial responses, and two minimal responses. Responses were observed in 9/14 patients (64%) with refractory anaemia (RA) and 2/6 patients (33%) with refractory anaemia with excess blasts (RAEB). Median response duration was 10 months (range 3-38 months). The Kaplan-Meier estimate of overall survival was 84% at 38 months, with one early death due to pneumonia and two deaths from disease progression to leukaemia. Side-effects consisted mainly of mild serum sickness in all patients. A single course of ATG restored haemopoiesis in some patients with MDS and was well tolerated.
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Affiliation(s)
- J J Molldrem
- Clinical Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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