Pediatric blood & cancer
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Pediatric blood & cancer · May 2008
ReviewRegistration and classification of adolescent and young adult cancer cases.
Cancer registries are an important research resource that facilitate the study of etiology, tumor biology, patterns of delayed diagnosis and health planning needs. When outcome data are included, registries can track secular changes in survival related to improvements in early detection or treatment. The surveillance, epidemiology, and end results (SEER) registry has been used to identify major gaps in survival for older adolescent and young adult (AYA) patients compared with younger children and older adults. ⋯ The central registration and classification issues for AYAs are case-finding, defining common data elements (CDE) collected across different registries and the diagnostic classification of these malignancies. Goals to achieve by 2010 include extending and validating current diagnostic classification schemes and expanding the CDE to support AYA oncology research, including the collection of tracking information to assess long-term outcomes. These efforts will advance preventive, etiologic, therapeutic, and health services-related research for this understudied age group.
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The fundamental purposes underlying formal health care transition from the pediatric to adult setting for young adult survivors of childhood cancer are to facilitate the continuous, medically and developmentally appropriate implementation of risk-based guidelines for the monitoring and management of late effects of childhood cancer and its treatment; and to support the normal maturational processes involved with growing from childhood to adulthood. To achieve these, this article identifies specific goals and action items in the following key areas: Models of Transitional Care, Survivor/Family Education, Post-Transitional Care Outcomes, Education of Health Care Professionals, and Health Care Policy and Advocacy.
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Pediatric blood & cancer · May 2008
Randomized Controlled TrialInitial testing of cisplatin by the pediatric preclinical testing program.
Cisplatin is one of the most widely used drugs for the treatment of solid tumors in adults and children. Here, we report the activity of cisplatin against the PPTP panels of childhood cancer xenografts. ⋯ Cisplatin exhibits significant antitumor activity against a broad range of solid tumor xenograft models and limited activity against ALL xenografts. This preclinical pattern of activity is generally consistent with cisplatin's clinical activity.
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Pediatric blood & cancer · May 2008
Integration of a palliative and terminal care center into a comprehensive pediatric oncology department.
The sharp division between curative cancer therapy and palliative care results in the late introduction of palliative care and a high incidence of suffering in children with cancer. We established a Palliative Care Unit (PCU) that is fully integrated with the Pediatric Hematology Oncology Department (PHOD). We wished to explore the impact of such integrative model on patterns of hospitalizations and exposure to palliative care of pediatric oncology patients. ⋯ Our integrative model results in exposure of the majority of children with cancer to palliative care. For poor prognosis patients, palliative care is introduced early enough to allow gradual transition from symptom control after diagnosis to end of life care.