Pediatric blood & cancer
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Pediatric blood & cancer · Dec 2014
Design of a drug-drug interaction study of vincristine with azole antifungals in pediatric cancer patients using clinical trial simulation.
The aim of the current work was to perform a clinical trial simulation (CTS) analysis to optimize a drug-drug interaction (DDI) study of vincristine in children who also received azole antifungals, taking into account challenges of conducting clinical trials in this population, and, to provide a motivating example of the application of CTS in the design of pediatric oncology clinical trials. ⋯ This work demonstrated the utility of CTS for the evaluation of PK clinical trial designs in the pediatric oncology population.
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Pediatric blood & cancer · Nov 2014
Case ReportsPilomyxoid astrocytoma treated successfully with vemurafenib.
The BRAF V600E missense mutation is known to be present in a subset of central nervous system tumors. We report a patient with a BRAF V600E mutated pilomyxoid astrocytoma who failed multiple conventional chemotherapy regimens. ⋯ Furthermore, this patient experienced almost immediate progression of disease after holding vemurafenib for only 2-3 weeks, suggesting that the tumor response is vemurafenib dependent. This population of patients may benefit from targeted therapy and testing of individual tumors for BRAF mutations is justified.
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There are limited data on the incidence of delirium in children with cancer. We performed a retrospective chart review of all pediatric oncology admissions over a 1 year period to determine the incidence of delirium in this population. ⋯ Delirium is associated with significant morbidity and mortality, and is likely under-recognized in this population. Improved diagnosis and treatment of delirium may improve outcomes in children with cancer.
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Pediatric blood & cancer · Nov 2014
Sustained complete molecular remission after imatinib discontinuation in children with chronic myeloid leukemia.
Approximately 40% of adults with chronic myeloid leukemia (CML) in prolonged complete molecular response (CMR) remain in CMR after imatinib discontinuation. Corresponding information in children is lacking. ⋯ Since adults with molecular relapse responded to re-introduction of imatinib, we postulated that treatment discontinuation in low risk children might be justified within clinical trials with close monitoring. This may help to minimize exposure to imatinib and its potential side effects.
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Pediatric blood & cancer · Nov 2014
Incidence of platinum-induced ototoxicity in pediatric patients in Quebec.
The antineoplastic agents cisplatin and carboplatin are widely-used and highly-effective against a variety of pediatric cancers. Unfortunately, ototoxicity is a frequently encountered side effect of platinum-based chemotherapy. There is currently no treatment or prevention for platinum-induced ototoxicity and development of hearing loss may lead to devastating consequences on the quality of life of pediatric cancer survivors. The objective of this study is to determine the incidence of platinum-induced ototoxicity in a large series of pediatric patients and to evaluate the incidence of progression of ototoxicity after completion of treatment. ⋯ Ototoxicity following chemotherapy with cisplatin or carboplatin is common and can frequently progress after the completion of treatment. Long-term follow-up is strongly recommended.