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Ho B, Arnoldo A, Zhong Y, Lu M, Torchia J, Yao F, Hawkins C, Huang A. Rapid, economical diagnostic classification of ATRT molecular subgroup using NanoString nCounter platform. Neurooncol Adv 2024; 6:vdae004. [PMID: 38292239 PMCID: PMC10825849 DOI: 10.1093/noajnl/vdae004] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Background Despite genomic simplicity, recent studies have reported at least 3 major atypical teratoid rhabdoid tumor (ATRT) subgroups with distinct molecular and clinical features. Reliable ATRT subgrouping in clinical settings remains challenging due to a lack of suitable biological markers, sample rarity, and the relatively high cost of conventional subgrouping methods. This study aimed to develop a reliable ATRT molecular stratification method to implement in clinical settings. Methods We have developed an ATRT subgroup predictor assay using a custom genes panel for the NanoString nCounter System and a flexible machine learning classifier package. Seventy-one ATRT primary tumors with matching gene expression array and NanoString data were used to construct a multi-algorithms ensemble classifier. Additional validation was performed using an independent gene expression array against the independently generated dataset. We also analyzed 11 extra-cranial rhabdoid tumors with our classifier and compared our approach against DNA methylation classification to evaluate the result consistency with existing methods. Results We have demonstrated that our novel ensemble classifier has an overall average of 93.6% accuracy in the validation dataset, and a striking 98.9% accuracy was achieved with the high-prediction score samples. Using our classifier, all analyzed extra-cranial rhabdoid tumors are classified as MYC subgroups. Compared with the DNA methylation classification, the results show high agreement, with 84.5% concordance and up to 95.8% concordance for high-confidence predictions. Conclusions Here we present a rapid, cost-effective, and accurate ATRT subgrouping assay applicable for clinical use.
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Affiliation(s)
- Ben Ho
- Division of Cell Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Arthur and Sonia Labatt Brain Tumor Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anthony Arnoldo
- Division of Pathology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Yvonne Zhong
- Division of Pathology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mei Lu
- Division of Cell Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Arthur and Sonia Labatt Brain Tumor Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Fupan Yao
- Arthur and Sonia Labatt Brain Tumor Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Cynthia Hawkins
- Division of Cell Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Arthur and Sonia Labatt Brain Tumor Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Pathology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Annie Huang
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Arthur and Sonia Labatt Brain Tumor Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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2
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Lim YS, Ho B, Goh YS. Effectiveness of game-based exercise interventions on modifiable cardiovascular risk factors of individuals with type two diabetes mellitus: A systematic review and meta-analysis. Worldviews Evid Based Nurs 2023; 20:377-400. [PMID: 36380456 DOI: 10.1111/wvn.12615] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/30/2022] [Accepted: 09/03/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Sedentary lifestyles have been identified as a major risk factor for cardiovascular complications for individuals with type 2 diabetes mellitus (T2DM). Using video-gaming components, game-based exercise interventions can encourage these individuals to engage in regular physical activity (PA), given their favorable interactive interfaces, feedback, and on-demand flow experiences. AIM To evaluate the effectiveness of game-based exercise interventions, on modifiable cardiovascular risk factors, quality of life, and PA levels among individuals with T2DM. METHODS Published and unpublished studies were retrieved from eight electronic databases and reference lists of the included studies. Articles included in this study were from the inception of the databases to January 2022. Two reviewers performed screening, quality appraisal, and data extraction independently. Meta-analyses were conducted for the primary and secondary outcomes through RevMan. The protocol was registered on PROSPERO (CRD42022298894). RESULTS Of the 11 selected studies involving 1045 individuals of both genders with T2DM, 9 were included in the meta-analyses for glycosylated hemoglobin, blood pressure (BP), low-density lipoprotein cholesterol, quality of life, and physical activity levels. The meta-analyses reported very small to large effect sizes favoring game-based exercise interventions. Large effect sizes were reported for systolic BP, diastolic BP, and quality of life measured through SF-12 Mental Component Summary scores. LINKING EVIDENCE TO ACTION Game-based exercise interventions may improve modifiable cardiovascular risk factors, quality of life, and PA levels among individuals with T2DM. Supervision, PA levels, or motivation can affect the effectiveness of game-based exercise interventions.
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Affiliation(s)
- Ye Sheng Lim
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Ben Ho
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Yong-Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
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3
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Tan D, Castle-Kirszbaum M, Mariajoseph FP, Kow CY, Ho B, Danks A, Goldschlager T, Kam J. The utility of internal spinal marking for intraoperative localisation: A systematic review. J Clin Neurosci 2023; 111:78-85. [PMID: 36989767 DOI: 10.1016/j.jocn.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/07/2022] [Accepted: 09/03/2022] [Indexed: 03/29/2023]
Abstract
BACKGROUND Incorrect level spinal surgery is an avoidable complication, with significant ramifications. Several pre-operative spinal marking techniques have been described to aid intraoperative localisation. METHODS A systematic search of Ovid MEDLINE, and EMBASE was performed from inception to July 2022. All publications describing cases of internal spinal marking were included for further analysis. 22 articles describing 503 patients satisfied our eligibility criteria. RESULTS A number of localisation techniques, including endovascular coiling (n = 16), fiducials (n = 177), dye (n = 109), needle/fixed wire (n = 199), cement (n = 4), and gadolinium tubes (n = 1) were described. The highest rates of technical success were observed with endovascular coiling, fiducials, cement and dye (100 %), and complication rates were lowest with endovascular coiling, fiducials and cement (0 %). CONCLUSIONS Overall, internal spinal marking was effective and safe. When considering practicality and efficacy, fiducial marking appears the optimal technique, as it can be performed in the outpatient setting under local anaesthesia. This review demonstrates the need for more targeted investigation into localisation methods in spinal surgery.
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Comitani F, Nash JO, Cohen-Gogo S, Chang AI, Wen TT, Maheshwari A, Goyal B, Tio ES, Tabatabaei K, Mayoh C, Zhao R, Ho B, Brunga L, Lawrence JEG, Balogh P, Flanagan AM, Teichmann S, Huang A, Ramaswamy V, Hitzler J, Wasserman JD, Gladdy RA, Dickson BC, Tabori U, Cowley MJ, Behjati S, Malkin D, Villani A, Irwin MS, Shlien A. Diagnostic classification of childhood cancer using multiscale transcriptomics. Nat Med 2023; 29:656-666. [PMID: 36932241 PMCID: PMC10033451 DOI: 10.1038/s41591-023-02221-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 01/13/2023] [Indexed: 03/19/2023]
Abstract
The causes of pediatric cancers' distinctiveness compared to adult-onset tumors of the same type are not completely clear and not fully explained by their genomes. In this study, we used an optimized multilevel RNA clustering approach to derive molecular definitions for most childhood cancers. Applying this method to 13,313 transcriptomes, we constructed a pediatric cancer atlas to explore age-associated changes. Tumor entities were sometimes unexpectedly grouped due to common lineages, drivers or stemness profiles. Some established entities were divided into subgroups that predicted outcome better than current diagnostic approaches. These definitions account for inter-tumoral and intra-tumoral heterogeneity and have the potential of enabling reproducible, quantifiable diagnostics. As a whole, childhood tumors had more transcriptional diversity than adult tumors, maintaining greater expression flexibility. To apply these insights, we designed an ensemble convolutional neural network classifier. We show that this tool was able to match or clarify the diagnosis for 85% of childhood tumors in a prospective cohort. If further validated, this framework could be extended to derive molecular definitions for all cancer types.
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Affiliation(s)
- Federico Comitani
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Joshua O Nash
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
- Laboratory of Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Sarah Cohen-Gogo
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Astra I Chang
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Timmy T Wen
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Anant Maheshwari
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Bipasha Goyal
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Earvin S Tio
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Kevin Tabatabaei
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Chelsea Mayoh
- Children's Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- School of Clinical Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - Regis Zhao
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ben Ho
- Laboratory of Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ledia Brunga
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Petra Balogh
- Department of Cellular and Molecular Pathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, UK
| | - Adrienne M Flanagan
- Department of Cellular and Molecular Pathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, UK
- Research Department of Pathology, University College London Cancer Institute, London, UK
| | | | - Annie Huang
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Vijay Ramaswamy
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
- Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Johann Hitzler
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
- Program in Developmental and Stem Cell Biology, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Jonathan D Wasserman
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Rebecca A Gladdy
- Department of Surgical Oncology, Princess Margaret Cancer Centre/Mount Sinai Hospital, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Brendan C Dickson
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - Uri Tabori
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mark J Cowley
- Children's Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- School of Clinical Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - Sam Behjati
- Wellcome Sanger Institute, Hinxton, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - David Malkin
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
- Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Anita Villani
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Meredith S Irwin
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
- Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Adam Shlien
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada.
- Laboratory of Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
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Teoh Y, Chan T, Tsang C, Li K, Cheng KC, Cho C, Chan HC, Chiu Y, Ho B, Li T, Law M, Lee Y, Cheng C, Lo K, Lam K, Chan K, So HS, Leung C, Chan C, Yiu M, Ng C, Poon V, Leung C, Chi-Fai N. Transurethral en bloc resection versus standard resection of bladder tumour: A multi-center randomized trial (EB-StaR Study). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00751-0] [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: 02/12/2023]
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Howden K, McDonald PJ, Kazina C, Ong A, Ho B, Huang A, Orr BA, Vanan MI. Sustained and durable response with Alisertib monotherapy in the treatment of relapsed Atypical Teratoid Rhabdoid Tumor (ATRT). Neurooncol Adv 2022; 4:vdac090. [PMID: 35967099 PMCID: PMC9370377 DOI: 10.1093/noajnl/vdac090] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Kaitlyn Howden
- Department of Pediatrics and Child Health , University of Manitoba
| | - Patrick J McDonald
- Department of Pediatrics and Child Health , University of Manitoba
- Section of Neurosurgery, University of Manitoba, Winnipeg , Manitoba, Canada
| | - Colin Kazina
- Department of Pediatrics and Child Health , University of Manitoba
- Section of Neurosurgery, University of Manitoba, Winnipeg , Manitoba, Canada
| | - Annie Ong
- Department of Pharmacy , Cancer Care Manitoba
| | - Ben Ho
- Department of Pediatrics, University of Toronto, Toronto , Ontario, Canada
- Division of Hematology-Oncology, Hospital for Sick Children, Toronto , Ontario, Canada
| | - Annie Huang
- Department of Pediatrics, University of Toronto, Toronto , Ontario, Canada
- Division of Hematology-Oncology, Hospital for Sick Children, Toronto , Ontario, Canada
| | - Brent A Orr
- Department of Pathology, St Jude Children’s Research Hospital , Memphis, Tennessee
| | - Magimairajan Issai Vanan
- Department of Pediatric Hematology & Oncology , Cancer Care Manitoba
- Department of Pediatrics and Child Health , University of Manitoba
- Cancer Care Manitoba Research Institute , University of Manitoba
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7
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de Faria FW, Walter C, Interlandi M, Melcher V, Riedel N, Graf M, Moreno N, Schoof M, Holdhof D, Thomas C, Frühwald MC, Maerkl B, Ho B, Sandmann S, Varghese J, Ebinger M, Schuhmann M, Canak A, Huang A, Schüller U, Albert TK, Kerl K. ETMR-05. Single-cell transcriptomics of ETMR reveals developmental cellular programs and tumor-pericyte communications in the microenvironment. Neuro Oncol 2022. [PMCID: PMC9165314 DOI: 10.1093/neuonc/noac079.183] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: Embryonal tumors with multilayered rosettes (ETMR) are pediatric brain tumors bearing a grim prognosis, despite intensive multimodal therapeutic approaches. Insights into cellular heterogeneity and cellular communication of tumor cells with cells of the tumor microenvironment (TME), by applying single-cell (sc) techniques, potentially identify mechanisms of therapy resistance and target-directed treatment approaches. MATERIAL AND METHODS: To explore ETMR cell diversity, we used single-cell RNA sequencing (scRNA-seq) in human (n=2) and murine ETMR (transgenic mode; n=4) samples, spatial transcriptomics, 2D and 3D cultures (including co-cultures with TME cells), multiplex immunohistochemistry and drug screens. RESULTS: ETMR microenvironment is composed of tumor and non-tumor cell types. The ETMR malignant compartment harbour cells representing distinct transcriptional metaprograms, (NSC-like, NProg-like and Neuroblast-like), mirroring embryonic neurogenic cell states and fuelled by neurogenic pathways (WNT, SHH, Hippo). The ETMR TME is composed of oligodendrocyte and neuronal progenitor cells, neuroblasts, microglia, and pericytes. Tumor-specific ligand-receptor interaction analysis showed enrichment of intercellular communication between NProg-like ETMR cells and pericytes (PC). Functional network analyses reveal ETMR-PC interactions related to stem-cell signalling and extracellular matrix (ECM) organization, involving factors of the WNT, BMP, and CxCl12 networks. Results from ETMR-PC co-culture and spatial transcriptomics pointed to a pivotal role of pericytes in keeping ETMR in a germinal neurogenic state, enriched in stem-cell signalling. Drug screening considering cellular heterogeneity and cellular communication suggested novel therapeutic approaches. CONCLUSION: ETMR demonstrated diversity in the microenvironment, with enrichment of cell-cell communications with pericytes, supporting stem-cell signalling and interfering in the organization of the tumor extracellular matrix. Targeting ETMR-PC interactions might bring new opportunities for target-directed therapy.
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Affiliation(s)
- Flavia W de Faria
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Münster, Münster , NRW , Germany
| | - Carolin Walter
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Münster, Münster , NRW , Germany
- Institute of Medical Informatics, Westphalian Wilhelms-University Münster, Münster , NRW , Germany
| | - Marta Interlandi
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Münster, Münster , NRW , Germany
- Institute of Medical Informatics, Westphalian Wilhelms-University Münster, Münster , NRW , Germany
| | - Viktoria Melcher
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Münster, Münster , NRW , Germany
| | - Nicole Riedel
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Münster, Münster , NRW , Germany
| | - Monika Graf
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Münster, Münster , NRW , Germany
| | - Natalia Moreno
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Münster, Münster , NRW , Germany
| | - Melanie Schoof
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf , Hamburg, HH , Germany
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf , Hamburg, HH , Germany
| | - Dörthe Holdhof
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf , Hamburg, HH , Germany
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf , Hamburg, HH , Germany
| | - Christian Thomas
- Institute of Neuropathology, University Hospital Münster, Münster , NRW , Germany
| | - Michael C Frühwald
- Swabian Children’s Cancer Center, Paediatric and Adolescent Medicine, University Medical Center Augsburg , Ausburg, Bavaria , Germany
| | - Bruno Maerkl
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg , Ausburg, Bavaria , Germany
| | - Ben Ho
- Department of Cell Biology, Hospital for Sick Children , Toronto, Ontario , Canada
| | - Sarah Sandmann
- Institute of Medical Informatics, Westphalian Wilhelms-University Münster, Münster , NRW , Germany
| | - Julian Varghese
- Institute of Medical Informatics, Westphalian Wilhelms-University Münster, Münster , NRW , Germany
| | - Martin Ebinger
- Department Pediatric Hematology/Oncology, Children’s University Hospital, Eberhard Karls University of Tuebingen, Tübingen , BW , Germany
- German Cancer Consortium (DKTK) partner site Tübingen, Tübingen , BW , Germany
| | - Martin Schuhmann
- Division of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tuebingen, Eberhard Karls University of Tuebingen, Tübingen , BW , Germany
| | - Aysegül Canak
- Department Pediatric Hematology/Oncology, Children’s University Hospital, Eberhard Karls University of Tuebingen, Tübingen , BW , Germany
| | - Annie Huang
- Division of Haematology Oncology, Department of Paediatrics, Hospital for Sick Children , Toronto, Ontario , Canada
- The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children , Toronto, Ontario , Canada
| | - Ulrich Schüller
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf , Hamburg, HH , Germany
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf , Hamburg, HH , Germany
| | - Thomas K Albert
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Münster, Münster , NRW , Germany
| | - Kornelius Kerl
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Münster, Münster , NRW , Germany
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8
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Liu L, Trivedi P, Ho B, Selph C, Hughes M, Casadaban L. Abstract No. 397 Adrenal vein sampling with slow infusion of Cosyntropin for identifying surgically curable cases. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.478] [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: 11/16/2022] Open
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9
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Lamichhane R, Roy P, Hawkins C, Zameer L, Gehani A, Achari RB, Ho B, Huang A, Tabori U, Ramaswamy V, Sukumaran RK, Das A. A novel central nervous system embryonal tumor successfully treated with multi-modal therapy highlights limitation of methylation-based tumor classification. Pediatr Blood Cancer 2022; 69:e29520. [PMID: 34913598 DOI: 10.1002/pbc.29520] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Ritu Lamichhane
- Department of Paediatric Haematology Oncology, Tata Medical Center, Kolkata, India
| | - Paromita Roy
- Department of Pathology, Tata Medical Center, Kolkata, India
| | - Cynthia Hawkins
- Department of Paediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Canada
| | - Lateef Zameer
- Department of Pathology, Tata Medical Center, Kolkata, India
| | - Anisha Gehani
- Department of Radiology, Tata Medical Center, Kolkata, India
| | - Rimpa B Achari
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Ben Ho
- The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Canada
| | - Annie Huang
- The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Canada.,Division of Haematology Oncology, Department of Paediatrics, Hospital for Sick Children, Toronto, Canada
| | - Uri Tabori
- The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Canada.,Division of Haematology Oncology, Department of Paediatrics, Hospital for Sick Children, Toronto, Canada
| | - Vijay Ramaswamy
- The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Canada.,Division of Haematology Oncology, Department of Paediatrics, Hospital for Sick Children, Toronto, Canada
| | - Reghu K Sukumaran
- Department of Paediatric Haematology Oncology, Tata Medical Center, Kolkata, India
| | - Anirban Das
- Department of Paediatric Haematology Oncology, Tata Medical Center, Kolkata, India.,The Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Canada.,Division of Haematology Oncology, Department of Paediatrics, Hospital for Sick Children, Toronto, Canada
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10
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Doan P, Counter W, Sheehan-Dare G, Papa N, Ho B, Lee J, Liu V, Thompson J, Agrawal S, Roberts M, Algharzo O, Buteau J, Hofman M, Moon D, Murphy D, Stricker P, Emmett L. Diagnostic accuracy, concordance and certainty with 68Ga-PSMA-11 PET/MRI fusion compared to mpMRI and 68Ga-PSMA-11 PET/CT alone for prostate cancer diagnosis: A PRIMARY trial sub-study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00822-3] [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: 11/24/2022]
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11
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Rubens JA, Erker C, Lindsay H, Ho B, Li B, Bouffet E, Cohen A, Eberhart C, Ertl-Wagner B, Mahajan A, Zacharoulis S, Huang A, Packer R. Infantile suprasellar tumor diagnosed as a pineoblastoma RB1 subgroup and treatment challenges: A pediatric SNO Molecular Tumor Board. Neurooncol Adv 2022; 4:vdac092. [PMID: 35821675 PMCID: PMC9268732 DOI: 10.1093/noajnl/vdac092] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jeffrey A Rubens
- Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University , Baltimore, Maryland , USA
| | - Craig Erker
- Division of Hematology/Oncology, Department of Paediatrics, IWK Health Centre and Dalhousie University , Halifax, Nova Scotia , Canada
| | - Holly Lindsay
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Texas Children’s Hospital/Baylor College of Medicine , Houston, Texas , USA
| | - Ben Ho
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto , Toronto, Ontario , Canada
| | - Bryan Li
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto , Toronto, Ontario , Canada
| | - Eric Bouffet
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto , Toronto, Ontario , Canada
| | - Alan Cohen
- Division of Neurosurgery, School of Medicine, Johns Hopkins University , Baltimore, Maryland , USA
| | - Charles Eberhart
- Division of Pathology, School of Medicine, Johns Hopkins University , Baltimore, Maryland , USA
| | - Birgit Ertl-Wagner
- Division of Neuroradiology, The Hospital for Sick Children, University of Toronto , Toronto, Ontario , Canada
| | - Anita Mahajan
- Department of Radiation Oncology, Mayo Clinic , Rochester, MN , USA
| | - Stergios Zacharoulis
- Department of Pediatrics, Columbia University Irving Medical Center , New York, New York , USA
| | - Annie Huang
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto , Toronto, Ontario , Canada
| | - Roger Packer
- The Brain Tumor Institute, Center for Neuroscience and Behavioral Medicine, Children’s National Health System , Washington, DC , USA
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12
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Khan S, Solano-Paez P, Suwal T, Lu M, Al-Karmi S, Ho B, Mumal I, Shago M, Hoffman LM, Dodgshun A, Nobusawa S, Tabori U, Bartels U, Ziegler DS, Hansford JR, Ramaswamy V, Hawkins C, Dufour C, André N, Bouffet E, Huang A. Clinical phenotypes and prognostic features of embryonal tumours with multi-layered rosettes: a Rare Brain Tumor Registry study. Lancet Child Adolesc Health 2021; 5:800-813. [PMID: 34599879 DOI: 10.1016/s2352-4642(21)00245-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/27/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Embryonal tumours with multi-layered rosettes (ETMRs) are a newly recognised, rare paediatric brain tumour with alterations of the C19MC microRNA locus. Due to varied diagnostic practices and scarce clinical data, disease features and determinants of outcomes for these tumours are poorly defined. We did an integrated clinicopathological and molecular analysis of primary ETMRs to define clinical phenotypes, and to identify prognostic factors of survival and key treatment modalities for this orphan disease. METHODS Paediatric patients with primary ETMRs and tissue available for analyses were identified from the Rare Brain Tumor Consortium global registry. The institutional histopathological diagnoses were centrally re-reviewed as per the current WHO CNS tumour guidelines, using histopathological and molecular assays. Only patients with complete clinical, treatment, and survival data on Nov 30, 2019, were included in clinicopathological analyses. Among patients who received primary multi-modal curative regimens, event-free survival and overall survival were determined using Cox proportional hazard and log-rank analyses. Univariate and multivariable Cox proportional hazard regression was used to estimate hazard ratios (HRs) with 95% CIs for clinical, molecular, or treatment-related prognostic factors. FINDINGS 159 patients had a confirmed molecular diagnosis of primary ETMRs (median age at diagnosis 26 months, IQR 18-36) and were included in our clinicopathological analysis. ETMRs were predominantly non-metastatic (94 [73%] of 128 patients), arising from multiple sites; 84 (55%) of 154 were cerebral tumours and 70 (45%) of 154 arose at sites characteristic of other brain tumours. Hallmark C19MC alterations were seen in 144 (91%) of 159 patients; 15 (9%) were ETMR not otherwise specified. In patients treated with curative intent, event-free survival was 57% (95% CI 47-68) at 6 months and 31% (21-42) at 2 years; overall survival was 29% (20-38) at 2 years and 27% (18-37) at 4 years. Overall survival was associated with non-metastatic disease (HR 0·48, 95% CI 0·28-0·80; p=0·0057) and non-brainstem location (0·42 [0·22-0·81]; p=0·013) on univariate analysis, as well as with gross total resection (0·30, 0·16-0·58; p=0·0014), high-dose chemotherapy (0·35, 0·19-0·67; p=0·0020), and radiotherapy (0·21, 0·10-0·41; p<0·0001) on multivariable analysis. 2-year event-free and overall survival was 0% at 2 years in patients treated with conventional chemotherapy without radiotherapy (regardless of surgery extent), and 21% (95% CI 1-41) and 30% (6-54), respectively, in patients treated with high-dose chemotherapy, and gross total resection without radiotherapy. 2-year event-free survival in patients treated with high-dose chemotherapy and radiotherapy was 66% (95% CI 39-93) for patients with gross total resection and 44% (7-81) for patients with sub-total resection. 2-5-year overall survival was 66% (95% CI 33-99, p=0·038) for patients with gross total resection and 67% (36-98, p=0·0020) for patients with sub-total resection. INTERPRETATION Prompt molecular diagnosis and post-surgical treatment with intensive multi-modal therapy tailored to patient-specific risk features could improve ETMR survival. FUNDING Canadian Institute of Health Research, Canada Research Chair Awards, Australian Lions Childhood Cancer Research Foundation, Spanish Society of Pediatrics, Consejería de Salud y Familias de la Junta de Andalucía, Miracle Marnie, Phoebe Rose Rocks, Tali's Funds, Garron Cancer Centre, Grace's Walk, Meagan's Hug, Brainchild, Nelina's Hope, and Jean Martel Foundation.
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Affiliation(s)
- Sara Khan
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Monash Children's Cancer Centre, Monash Children's Hospital, Monash Health, Melbourne, VIC, Australia; Center for Cancer Research, Hudson Institute of Medical Research, Melbourne, VIC, Australia; Department of Molecular and Translational Science, School of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, Australia
| | - Palma Solano-Paez
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, CSIC, Universidad de Sevilla, Seville, Spain
| | - Tannu Suwal
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mei Lu
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Salma Al-Karmi
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Ben Ho
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Iqra Mumal
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mary Shago
- Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lindsey M Hoffman
- Division of Hematology/Oncology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Andrew Dodgshun
- Children's Haematology/Oncology Centre, Christchurch Hospital, Christchurch, New Zealand
| | | | - Uri Tabori
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Division of Haematology/Oncology, Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Ute Bartels
- Division of Haematology/Oncology, Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - David S Ziegler
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jordan R Hansford
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Vijay Ramaswamy
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Division of Haematology/Oncology, Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Cynthia Hawkins
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Christelle Dufour
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy, Villejuif, France
| | - Nicolas André
- Pediatric Oncology, Children Hospital of La Timone, AP-HM, SMARTc unit Centre de Recherche en Cancérologie de Marseille, INSERM U1068, Aix-Marseille University, Marseille, France
| | - Eric Bouffet
- Division of Haematology/Oncology, Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Annie Huang
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Division of Haematology/Oncology, Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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13
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Ra AG, Ho B, Bickerstaffe L, Bewley A. More than skin deep: a survey of real-life experiences of acne vulgaris. Br J Dermatol 2021; 186:191-193. [PMID: 34473341 DOI: 10.1111/bjd.20737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/08/2021] [Accepted: 08/28/2021] [Indexed: 01/18/2023]
Affiliation(s)
- A G Ra
- Salford Royal NHS Foundation Trust, Salford, UK.,St George's Hospital NHS Foundation Trust, London, UK
| | - B Ho
- St George's Hospital NHS Foundation Trust, London, UK
| | | | - A Bewley
- Barts Health NHS Trust, London, UK
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14
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Reddy A, Biegel J, Huang A, Strother D, Judkins A, Pollack I, Buxton A, Mahajan A, Ho B, Mazewski C, Lewis V, Fouladi M, Krailo M. ATRT-04. CORRELATION OF CLINICOPATHOLOGIC FEATURES AND CUMULATIVE INCIDENCE OF RELAPSE FOR PATIENTS WITH ATYPICAL TERATOID RHABDOID TUMOR ON ACNS0333: A REPORT FROM THE CHILDREN’S ONCOLOGY GROUP. Neuro Oncol 2021. [PMCID: PMC8168123 DOI: 10.1093/neuonc/noab090.003] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose Intensive multi-modal regimens have improved survival for patients with atypical teratoid rhabdoid tumor, however relapse rates remain high. A better understanding of clinical and pathologic features associated with tumor relapse is critical to risk-stratifying patients. Patients and Methods ACNS0333 treatment consisted of multi-agent chemotherapy, high-dose chemotherapy, and radiation therapy, lasting approximately 6 months. Variables including patient age, sex, tumor location, M-stage, degree of resection, order of therapy, germline status, and molecular subgroup were analyzed. Cumulative incidence (CI) of event free survival due to relapse was evaluated for each variable. Results Thirty-three of 65 evaluable patients had tumor relapse. For the entire cohort, the CI of relapse was 21.8% at 6 months, 40.6% at one year and 50.3% at 4 years. For patients with infratentorial tumors, CI of relapse was 26.3%, 34.2% and 37.2%, at 6 months, 1 and 4 years respectfully compared to 15.3%, 49.9%, and 69.7% for those with supratentorial tumors (p 0.051). Patients with SHH subtype had no relapses in the first 6 months and CI of relapse of 37.5% at 4 years, while those with TYR and MYC subgroups had CI of relapse of 33.3% and 26.7% at 6 months and 46.3% and 73.3% at 4 years respectfully (p 0.088). Patients with germline mutations had a cumulative incidence of relapse of 20% at 6 months and 60% at 12 months compared to 22.6% and 37.7% respectfully for those without. No obvious trends were noted based on other analyzed variables. Conclusions ACNS0333 was not powered to determine prognostic indicators of relapse, however, this data suggest interesting trends based on tumor location, subtype and germline status. Infratentorial location and SHH subtype maybe associated with lower risk of relapse. Larger data sets must be compiled to further investigate these variables, perform multivariate analyses and inform risk-stratification on future trials.
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Affiliation(s)
- Alyssa Reddy
- University of California – San Francisco, San Francisco, CA, USA
| | - Jaclyn Biegel
- University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Ian Pollack
- Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Ben Ho
- Hospital for Sick Children, Toronto, Canada
| | | | | | - Maryam Fouladi
- Ohio State University College of Medicine, Columbus, OH, USA
| | - Mark Krailo
- University of Southern California, Los Angeles, CA, USA
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15
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Ho B, Johann PD, Grabovska Y, De Dieu Andrianteranagna MJ, Yao F, Frühwald M, Hasselblatt M, Bourdeaut F, Williamson D, Huang A, Kool M. Molecular subgrouping of atypical teratoid/rhabdoid tumors-a reinvestigation and current consensus. Neuro Oncol 2021; 22:613-624. [PMID: 31889194 PMCID: PMC7229260 DOI: 10.1093/neuonc/noz235] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Atypical teratoid/rhabdoid tumors (ATRTs) are known to exhibit molecular and clinical heterogeneity even though SMARCB1 inactivation is the sole recurrent genetic event present in nearly all cases. Indeed, recent studies demonstrated 3 molecular subgroups of ATRTs that are genetically, epigenetically, and clinically distinct. As these studies included different numbers of tumors, various subgrouping techniques, and naming, an international working group sought to align previous findings and to reach a consensus on nomenclature and clinicopathological significance of ATRT subgroups. Methods We integrated various methods to perform a meta-analysis on published and unpublished DNA methylation and gene expression datasets of ATRTs and associated clinicopathological data. Results In concordance with previous studies, the analyses identified 3 main molecular subgroups of ATRTs, for which a consensus was reached to name them ATRT-TYR, ATRT-SHH, and ATRT-MYC. The ATRT-SHH subgroup exhibited further heterogeneity, segregating further into 2 subtypes associated with a predominant supratentorial (ATRT-SHH-1) or infratentorial (ATRT-SHH-2) location. For each ATRT subgroup we provide an overview of its main molecular and clinical characteristics, including SMARCB1 alterations and pathway activation. Conclusions The introduction of a common classification, characterization, and nomenclature of ATRT subgroups will facilitate future research and serve as a common ground for subgrouping patient samples and ATRT models, which will aid in refining subgroup-based therapies for ATRT patients.
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Affiliation(s)
- Ben Ho
- Division of Hematology and Oncology, Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Pascal D Johann
- Hopp Children's Cancer Center, Heidelberg, Germany.,Division of Pediatric Neuro-oncology, German Cancer Research Center and German Cancer Research Consortium, Heidelberg, Germany.,Department of Pediatric Hematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Yura Grabovska
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Mamy Jean De Dieu Andrianteranagna
- Departments of Genetics and of Oncopediatry and Young Adults, Curie Institute, Paris, France.,INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Curie Institute, Paris, France
| | - Fupan Yao
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael Frühwald
- University Children's Hospital Augsburg, Swabian Children's Cancer Center, Augsburg, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Franck Bourdeaut
- Departments of Genetics and of Oncopediatry and Young Adults, Curie Institute, Paris, France.,INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Curie Institute, Paris, France
| | - Daniel Williamson
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Annie Huang
- Division of Hematology and Oncology, Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Marcel Kool
- Hopp Children's Cancer Center, Heidelberg, Germany.,Division of Pediatric Neuro-oncology, German Cancer Research Center and German Cancer Research Consortium, Heidelberg, Germany
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16
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Hoffman LM, Richardson EA, Ho B, Margol A, Reddy A, Lafay-Cousin L, Chi S, Slavc I, Judkins A, Hasselblatt M, Bourdeaut F, Frühwald MC, Vibhakar R, Bouffet E, Huang A. Advancing biology-based therapeutic approaches for atypical teratoid rhabdoid tumors. Neuro Oncol 2021; 22:944-954. [PMID: 32129445 DOI: 10.1093/neuonc/noaa046] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Atypical teratoid rhabdoid tumor (ATRT) is a rare, highly malignant central nervous system cancer arising in infants and younger children, historically considered to be homogeneous, monogenic, and incurable. Recent use of intensified therapies has modestly improved survival for ATRT; however, a majority of patients will still succumb to their disease. While ATRTs almost universally exhibit loss of SMARCB1 (BAF47/INI1/SNF5), recent whole genome, transcriptome, and epigenomic analyses of large cohorts reveal previously underappreciated molecular heterogeneity. These discoveries provide novel insights into how SMARCB1 loss drives oncogenesis and confer specific therapeutic vulnerabilities, raising exciting prospects for molecularly stratified treatment for patients with ATRT.
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Affiliation(s)
- Lindsey M Hoffman
- Center for Cancer and Blood Disorders, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Elizabeth Anne Richardson
- Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ben Ho
- Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ashley Margol
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, California, USA.,Department of Pediatrics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Alyssa Reddy
- Departments of Neurology and Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Lucie Lafay-Cousin
- Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Alberta Children's Hospital, Calgary, Alberta, Canada.,Department of Paediatrics and Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan Chi
- Pediatric Medical Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Irene Slavc
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Alexander Judkins
- Center for Personalized Medicine, Children's Hospital of Los Angeles.,Pathology and Laboratory Medicine, Children's Hospital of Los Angeles.,Department of Pathology, Keck School of Medicine University of Southern California, Los Angeles, California, USA
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Franck Bourdeaut
- Curie Institute, Integrated Cancer Research Site, Paris, France.,Departments of Genetics and of Oncopediatry and Young Adults, Curie Institute, Paris, France.,INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Curie Institute, Paris, France
| | - Michael C Frühwald
- Swabian Children's Cancer Center, University Children's Hospital, University Hospital Augsburg, Augsburg, Germany.,Department of Pediatric Hematology and Oncology, University Children's Hospital Münster, University of Münster, Münster, Germany.,EU-RHAB Registry Working Group, Augsburg, Germany
| | - Rajeev Vibhakar
- Department of Pediatrics, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA.,Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA.,Department of Neurosurgery, University of Colorado Denver, Aurora, Colorado, USA
| | - Eric Bouffet
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.,Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Annie Huang
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.,Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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17
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Ferguson L, Ho B, Weir J, Francis N, West K, Rathbone B, Larkin J, Heelan K. Extensive mucocutaneous, oesophageal and otic lichen planus secondary to nivolumab therapy. Skin Health Dis 2021; 1:e8. [PMID: 35664814 PMCID: PMC9060137 DOI: 10.1002/ski2.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 02/01/2023]
Abstract
We report a 73-year-old female with metastatic renal cell carcinoma who developed a widespread lichenoid reaction following nivolumab treatment. The timeline of the reaction strongly correlated with the nivolumab treatment and subsequent cessation. Our patient had cutaneous, mucosal, otic, ophthalmic and oesophageal involvement, demonstrating the potentially extensive nature of lichenoid reactions to anti-programmed cell death receptor-1 (anti-PD1) therapies. Although lichenoid reactions to anti-PD1 therapies are now well recognized, there have been no previous reports of otic or oesophageal involvement in the literature. Although cutaneous lichenoid reactions do not tend to be severe or treatment limiting, more widespread systemic lichenoid reactions are challenging to manage, particularly in the context of malignancy. This very unusual case highlights the importance of considering involvement beyond the skin in all lichenoid skin reactions.
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Affiliation(s)
| | - B. Ho
- Dermatology DepartmentSt George's University Hospitals NHS Foundation TrustLondonUK
| | - J. Weir
- Department of HistopathologyImperial College Healthcare NHS TrustLondonUK
| | - N. Francis
- Department of HistopathologyImperial College Healthcare NHS TrustLondonUK
| | - K. West
- Histopathology DepartmentLeicester Royal InfirmaryLeicesterUK
| | - B. Rathbone
- Gastroenterology DepartmentLeicester Royal InfirmaryLeicesterUK
| | - J. Larkin
- Royal Marsden Hospital NHS TrustLondonUK
| | - K. Heelan
- Royal Marsden Hospital NHS TrustLondonUK
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18
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Holdhof D, Johann PD, Spohn M, Bockmayr M, Safaei S, Joshi P, Masliah-Planchon J, Ho B, Andrianteranagna M, Bourdeaut F, Huang A, Kool M, Upadhyaya SA, Bendel AE, Indenbirken D, Foulkes WD, Bush JW, Creytens D, Kordes U, Frühwald MC, Hasselblatt M, Schüller U. Atypical teratoid/rhabdoid tumors (ATRTs) with SMARCA4 mutation are molecularly distinct from SMARCB1-deficient cases. Acta Neuropathol 2021; 141:291-301. [PMID: 33331994 PMCID: PMC7847432 DOI: 10.1007/s00401-020-02250-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022]
Abstract
Atypical teratoid/rhabdoid tumors (ATRTs) are very aggressive childhood malignancies of the central nervous system. The underlying genetic cause are inactivating bi-allelic mutations in SMARCB1 or (rarely) in SMARCA4. ATRT-SMARCA4 have been associated with a higher frequency of germline mutations, younger age, and an inferior prognosis in comparison to SMARCB1 mutated cases. Based on their DNA methylation profiles and transcriptomics, SMARCB1 mutated ATRTs have been divided into three distinct molecular subgroups: ATRT-TYR, ATRT-SHH, and ATRT-MYC. These subgroups differ in terms of age at diagnosis, tumor location, type of SMARCB1 alterations, and overall survival. ATRT-SMARCA4 are, however, less well understood, and it remains unknown, whether they belong to one of the described ATRT subgroups. Here, we examined 14 ATRT-SMARCA4 by global DNA methylation analyses. We show that they form a separate group segregating from SMARCB1 mutated ATRTs and from other SMARCA4-deficient tumors like small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) or SMARCA4 mutated extra-cranial malignant rhabdoid tumors. In contrast, medulloblastoma (MB) samples with heterozygous SMARCA4 mutations do not group separately, but with established MB subgroups. RNA sequencing of ATRT-SMARCA4 confirmed the clustering results based on DNA methylation profiling and displayed an absence of typical signature genes upregulated in SMARCB1 deleted ATRT. In summary, our results suggest that, in line with previous clinical observations, ATRT-SMARCA4 should be regarded as a distinct molecular subgroup.
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Affiliation(s)
- Dörthe Holdhof
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Research Institute Children's Cancer Center Hamburg, Martinistrasse 52, N63 (HPI), 20251, Hamburg, Germany
| | - Pascal D Johann
- Paediatric and Adolescent Medicine, Swabian Childrens' Cancer Center Augsburg, Augsburg, Germany
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Research Consortium (DKTK), Heidelberg, Germany
| | - Michael Spohn
- Research Institute Children's Cancer Center Hamburg, Martinistrasse 52, N63 (HPI), 20251, Hamburg, Germany
| | - Michael Bockmayr
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Research Institute Children's Cancer Center Hamburg, Martinistrasse 52, N63 (HPI), 20251, Hamburg, Germany
- Institute of Pathology, Corporate Member of Freie Universität Berlin, Charité, Universitätsmedizin Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sepehr Safaei
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Research Institute Children's Cancer Center Hamburg, Martinistrasse 52, N63 (HPI), 20251, Hamburg, Germany
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Piyush Joshi
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Research Consortium (DKTK), Heidelberg, Germany
| | - Julien Masliah-Planchon
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Curie Institute, Paris, France
| | - Ben Ho
- Division of Hematology and Oncology, Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Mamy Andrianteranagna
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Curie Institute, Paris, France
- INSERM U900, CBIO-Centre for Computational Biology, MINES ParisTech, PSL Research University, Curie Institute, Paris, France
| | - Franck Bourdeaut
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Curie Institute, Paris, France
- Departments of Genetics and of Oncopediatry and Young Adults, Curie Institute, Paris, France
| | - Annie Huang
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Curie Institute, Paris, France
| | - Marcel Kool
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Research Consortium (DKTK), Heidelberg, Germany
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Santhosh A Upadhyaya
- Department of Oncology, St Jude Children's Research Hospital, Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Anne E Bendel
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Daniela Indenbirken
- Heinrich-Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - William D Foulkes
- Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Jonathan W Bush
- Division of Anatomical Pathology, British Columbia Children's Hospital and Women's Hospital and Health Center, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | - David Creytens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Uwe Kordes
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael C Frühwald
- Paediatric and Adolescent Medicine, Swabian Childrens' Cancer Center Augsburg, Augsburg, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Ulrich Schüller
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Research Institute Children's Cancer Center Hamburg, Martinistrasse 52, N63 (HPI), 20251, Hamburg, Germany.
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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19
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Tan S, Abrahams T, Splatt L, Ho B. Thrombosis of Mechanical Mitral Valve Prosthesis Treated With Fibrinolysis. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.366] [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: 11/29/2022]
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20
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Chung J, Maruvka YE, Sudhaman S, Kelly J, Haradhvala NJ, Bianchi V, Edwards M, Forster VJ, Nunes NM, Galati MA, Komosa M, Deshmukh S, Cabric V, Davidson S, Zatzman M, Light N, Hayes R, Brunga L, Anderson ND, Ho B, Hodel KP, Siddaway R, Morrissy AS, Bowers DC, Larouche V, Bronsema A, Osborn M, Cole KA, Opocher E, Mason G, Thomas GA, George B, Ziegler DS, Lindhorst S, Vanan M, Yalon-Oren M, Reddy AT, Massimino M, Tomboc P, Van Damme A, Lossos A, Durno C, Aronson M, Morgenstern DA, Bouffet E, Huang A, Taylor MD, Villani A, Malkin D, Hawkins CE, Pursell ZF, Shlien A, Kunkel TA, Getz G, Tabori U. DNA Polymerase and Mismatch Repair Exert Distinct Microsatellite Instability Signatures in Normal and Malignant Human Cells. Cancer Discov 2020; 11:1176-1191. [PMID: 33355208 DOI: 10.1158/2159-8290.cd-20-0790] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/23/2020] [Accepted: 12/15/2020] [Indexed: 12/11/2022]
Abstract
Although replication repair deficiency, either by mismatch repair deficiency (MMRD) and/or loss of DNA polymerase proofreading, can cause hypermutation in cancer, microsatellite instability (MSI) is considered a hallmark of MMRD alone. By genome-wide analysis of tumors with germline and somatic deficiencies in replication repair, we reveal a novel association between loss of polymerase proofreading and MSI, especially when both components are lost. Analysis of indels in microsatellites (MS-indels) identified five distinct signatures (MS-sigs). MMRD MS-sigs are dominated by multibase losses, whereas mutant-polymerase MS-sigs contain primarily single-base gains. MS deletions in MMRD tumors depend on the original size of the MS and converge to a preferred length, providing mechanistic insight. Finally, we demonstrate that MS-sigs can be a powerful clinical tool for managing individuals with germline MMRD and replication repair-deficient cancers, as they can detect the replication repair deficiency in normal cells and predict their response to immunotherapy. SIGNIFICANCE: Exome- and genome-wide MSI analysis reveals novel signatures that are uniquely attributed to mismatch repair and DNA polymerase. This provides new mechanistic insight into MS maintenance and can be applied clinically for diagnosis of replication repair deficiency and immunotherapy response prediction.This article is highlighted in the In This Issue feature, p. 995.
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Affiliation(s)
- Jiil Chung
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Yosef E Maruvka
- Massachusetts General Hospital Center for Cancer Research, Charlestown, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Sumedha Sudhaman
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jacalyn Kelly
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nicholas J Haradhvala
- Massachusetts General Hospital Center for Cancer Research, Charlestown, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Harvard Graduate Program in Biophysics, Harvard University, Cambridge, Massachusetts
| | - Vanessa Bianchi
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Melissa Edwards
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Victoria J Forster
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nuno M Nunes
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Melissa A Galati
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Martin Komosa
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shriya Deshmukh
- Department of Experimental Medicine, McGill University, Montreal, Quebec, Canada.,The Research Institute of the McGill University Health Center, Montreal, Quebec, Canada
| | - Vanja Cabric
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Scott Davidson
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Matthew Zatzman
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nicholas Light
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Reid Hayes
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ledia Brunga
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nathaniel D Anderson
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ben Ho
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Karl P Hodel
- Department of Biochemistry and Molecular Biology, Tulane Cancer Center, Tulane University of Medicine, New Orleans, Louisiana
| | - Robert Siddaway
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - A Sorana Morrissy
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Charbonneau Cancer Institute and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Daniel C Bowers
- Department of Pediatrics and Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas.,Pauline Allen Gill Center for Cancer and Blood Disorders, Children's Health, Dallas, Texas
| | - Valérie Larouche
- Department of Pediatrics, Centre Mere-enfant Soleil du CHU de Quebec, CRCHU de Quebec, Universite Laval, Quebec City, Quebec, Canada
| | - Annika Bronsema
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Osborn
- Department of Haematology and Oncology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Kristina A Cole
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Enrico Opocher
- Pediatric Oncology and Hematology, Azienda Ospedaliera-Universita' degli Studi di Padova, Padova, Italy
| | - Gary Mason
- Department of Pediatric Hematology-Oncology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
| | - Gregory A Thomas
- Division of Pediatric Hematology-Oncology, Oregon Health and Science University, Portland, Oregon
| | - Ben George
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - David S Ziegler
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Scott Lindhorst
- Neuro-Oncology, Department of Neurosurgery, and Department of Medicine, Division of Hematology/Medical Oncology, Medical University of South Carolina Charleston, South Carolina
| | - Magimairajan Vanan
- Department of Pediatric Hematology-Oncology, Cancer Care Manitoba; Research Institute in Oncology and Hematology (RIOH), University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michal Yalon-Oren
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Tel Hashomer Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Alyssa T Reddy
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Maura Massimino
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milano, Italy
| | - Patrick Tomboc
- Department of Pediatrics Section of Hematology-Oncology, WVU Medicine Children's, Morgantown, West Virginia
| | - An Van Damme
- Division of Hematology and Oncology, Department of Pediatrics, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Alexander Lossos
- Department of Neurology, Agnes Ginges Center for Human Neurogenetics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Carol Durno
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, Ontario, Canada.,Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Melyssa Aronson
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Daniel A Morgenstern
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Eric Bouffet
- Department of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Annie Huang
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael D Taylor
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anita Villani
- Department of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - David Malkin
- Department of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Cynthia E Hawkins
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Program in Cell Biology, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Zachary F Pursell
- Department of Biochemistry and Molecular Biology, Tulane Cancer Center, Tulane University of Medicine, New Orleans, Louisiana
| | - Adam Shlien
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Thomas A Kunkel
- Genome Integrity Structural Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Durham, North Carolina
| | - Gad Getz
- Massachusetts General Hospital Center for Cancer Research, Charlestown, Massachusetts. .,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | - Uri Tabori
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada. .,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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21
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Ho B, Johann PD, Grabovska Y, De Dieu Andrianteranagna MJ, Yao FP, Frühwald M, Hasselblatt M, Bourdeaut F, Williamson D, Huang A, Kool M. Corrigendum to: Molecular subgrouping of atypical teratoid/rhabdoid tumors-a reinvestigation and current consensus. Neuro Oncol 2020; 24:1213. [PMID: 33283872 PMCID: PMC9248380 DOI: 10.1093/neuonc/noaa210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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Khan S, Solano-Paez P, Suwal T, Al-Karmi S, Lu M, Ho B, Fouladi M, Leary S, Levy JMM, Lassaletta A, Rivas E, Reddy A, Gillespie GY, Gupta N, Yalon-Oren M, Amariglio L, Nakamura H, Wu KS, Wong TT, Ra YS, Spina ML, Emanuele PV, Massimi L, Buccoliero AM, Hansford JR, Grundy RG, Adamek D, Fangusaro J, Scharnhorst D, Johnston D, Lafay-Cousin L, Camelo-Piragua S, Kabbara N, Gajjar A, Boutarbouch M, da Costa MJG, Hanson D, Wood P, Al-Hussaini M, Amayiri N, Wang Y, Catchpoole D, Michaud J, Bendel AE, Ellezam B, Gerber N, Plant A, Jeffery R, Dunham C, Moertel C, Walter A, Ziegler D, Dodgshun A, Gottardo N, Demir A, Ramanujachar R, Raabe E, Mary S, Dirks P, Taylor M, Eugene H, Lindsey H, Tihan T, Mette J, Dahl C, Low S, Smith A, Hazrati LN, Kresak J, Gino S, Tan E, Morales A, Santa-Maria V, Hawkins C, Bartels U, Stephens D, Nobusawa S, Dufour C, Bourdeaut F, Andre N, Bouffet E, Huang A. ETMR-22. TITLE: DEFINING THE CLINICAL AND PROGNOSTIC LANDSCAPE OF EMBRYONAL TUMORS WITH MULTI-LAYERED ROSETTES (ETMRs), A RARE BRAIN TUMOR REGISTRY (RBTC) STUDY. Neuro Oncol 2020. [PMCID: PMC7715263 DOI: 10.1093/neuonc/noaa222.225] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
ETMR, an aggressive disease characterised by C19MC alterations, were previously categorised as various histologic diagnoses. The clinical spectrum and impact of conventional multi-modal therapy on this new WHO diagnostic category remains poorly understood as a majority of ~200 cases reported to date lack molecular confirmation. We undertook comprehensive clinico-pathologic studies of a large molecularly confirmed cohort to improve disease recognition and treatment approaches. Amongst 623 CNS-PNETs patients enrolled in the RBTC registry, 159 primary ETMRs were confirmed based on a combination of FISH (125), methylation analysis (88), SNP and RNAseq (32) analyses; 91% had C19MC amplification/gains/fusions, 9% lacked C19MC alterations but had global methylation features of ETMR NOS. ETMRs arose in young patients (median age 26 months) predominantly as localized disease (M0-72%, M2-3 -18%) at multiple locations including cerebrum (60%) cerebellum (18%), midline structures (6%); notably 10% were brainstem primaries mimicking DIPG. Uni-and multivariate analyses of clinical and treatment details of curative regimens available for 110 patients identified metastatic disease (p=0.002), brainstem locations(p=0.005), extent of surgery, receipt of multi-modal therapy including high dose chemotherapy and radiation (P<0.001) as significant treatment prognosticators, while C19MC status, age and gender were non-significant risk factors. Analyses of events in all patients showed respective EFS at 3 and 12 months of 84%(95%CI:77–91) and 37%(95%CI:20–41) and 4yr OS of 27%(95%CI:18–37) indicating despite intensified therapies ETMR is a rapidly progressive and fatal disease. Our comprehensive data on the largest cohort of molecularly-confirmed ETMRs provides a critical framework to guide current clinical management and development of clinical trials.
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Affiliation(s)
- Sara Khan
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, Ontario, Canada
- Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia
| | - Palma Solano-Paez
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatric Oncology, Hospital Infantil Virgen del Rocio, Sevilla, Spain
| | - Tannu Suwal
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Salma Al-Karmi
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Mei Lu
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, Ontario, Canada
| | - Ben Ho
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, Ontario, Canada
| | - Maryam Fouladi
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Sarah Leary
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, WA, USA
| | | | - Alvaro Lassaletta
- Pediatric Hematology and Oncology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Eloy Rivas
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Alyssa Reddy
- University of Alabama at Birmingham, Birmingham, USA
| | - G Yancey Gillespie
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, USA
| | - Nalin Gupta
- Department of Neurological Surgery, University of California, California, San Francisco, CA, USA
| | - Michal Yalon-Oren
- Department of Pediatric Neuro-Oncology, Sheba Medical Centre, Tel HaShomer, Ramat Gan, Israel
| | - Laura Amariglio
- Department of Pediatric Neuro-Oncology, Sheba Medical Centre, Tel HaShomer, Ramat Gan, Israel
| | - Hideo Nakamura
- Department of Neurosurgery, Kumamoto University, Kumamoto, Japan
| | | | | | - Young-Shin Ra
- Department of Neurosurgery, Asan Medical Center, Seoul, Repulic of Korea
| | - Milena La Spina
- Paediatric Haematology and Oncology Division, University of Catania, Sicily, Italy
| | | | - Luca Massimi
- Department of Neurosurgery, Agostino Gemelli University Hospital, Rome, Italy
| | | | - Jordan R Hansford
- Children’s Cancer Centre, Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Richard G Grundy
- Children’s Brain Tumor Research Centre, Queen’s Medical Centre University of Nottingham, Nottingham, United Kingdom
| | - Dariusz Adamek
- Department of Pathomorphology, Jagiellonian University Medical College, Krakow, Poland
| | - Jason Fangusaro
- Department of Pediatric Hematology and Oncology, Children’s Healthcare of Atlanta and the Emory University School of Medicine, Atlanta, GA, USA
| | - David Scharnhorst
- Department of Pathology, Valley Children’s Hospital, Madera, CA, USA
| | - Donna Johnston
- Department of Pediatrics Division of Hematology/Oncology, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Lucie Lafay-Cousin
- Department of Pediatric Oncology, Alberta Children’s Hospital, Calgary, AB, Canada
| | | | - Nabil Kabbara
- Division of Pediatric Hematology Oncology, Rafic Hariri University Hospital, Beirut, Lebanon
| | - Amar Gajjar
- Division of Neuro-Oncology, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Mahjouba Boutarbouch
- Department of Neurosurgery, Mohamed Vth, University, School of Medicine, Hôpital des Spécialités, ONO CHU Ibn Sina, Rabat, Morocco
| | - Maria Joao Gil da Costa
- Pediatric Hemathology and Oncology Division, University Hospital S, João Alameda Hernani Monteiro, Porto, Portugal
| | - Derek Hanson
- Division of Hematology-Oncology, Steven and Alexandra Cohen Children’s Medical Center, Northwell Health, New York, NY, USA
- Children’s Hospital, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Paul Wood
- Monash Children’s Hospital, Melbourne, VIC, Australia
| | | | | | - Yin Wang
- Department of Neuropathology Huashan Hospital Fudan University, Shanghai, China
| | - Daniel Catchpoole
- The Tumour Bank, Children’s Cancer Research Unit, Kids Research Institute, the Children’s Hospital at Westmead, NSW, Australia
| | - Jean Michaud
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Eastern Ontario, Ottawa, Canada
| | - Anne E Bendel
- University of Minnesota Medical School Minneapolis, MN, USA
| | - Benjamin Ellezam
- Department of Pathology, CHU Sainte-Justine Research Center, Université de Montréal, Montreal, QC, Canada
| | - Nicholas Gerber
- Department of Oncology, University Children’s Hospital, Zurich, Switzerland
| | - Ashley Plant
- Division of Pediatric Oncology, Children’s Hospital of Orange County, Orange, CA, USA
| | - Rubens Jeffery
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christopher Dunham
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Christopher Moertel
- Pediatric Hematology-Oncology, Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN, USA
| | - Andrew Walter
- Division of Pediatric Hematology/Oncology duPont Hospital for Children, Wilmington, DE, USA
| | - David Ziegler
- Children’s Cancer Institute, University of New South Wales, NSW, Australia
| | - Andrew Dodgshun
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | | | - Ahmet Demir
- Department of Hematology, Trakya University Medical Faculty, Edirne, Turkey
| | - Ramya Ramanujachar
- Paediatric Haematology and Oncology, Southampton Children’s Hospital, South Hampton, United Kingdom
| | - Eric Raabe
- Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Division of Pediatric Oncology, Baltimore, MD, USA
| | - Shago Mary
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Peter Dirks
- The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Hwang Eugene
- Department of Oncology, Children’s National Medical Center, Washington, DC, USA
| | - Holly Lindsey
- Center for Cancer and Blood Disorders, Phoenix Children’s Hospital, Phoenix, AZ, USA
| | - Tarik Tihan
- Department of Pathology, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Jorgensen Mette
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Christine Dahl
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Sharon Low
- Neurology Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Amy Smith
- Orlando Regional Medical Center, Orlando, FL, USA
| | | | - Jesse Kresak
- Orlando Regional Medical Center, Orlando, FL, USA
| | - Somers Gino
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Enrica Tan
- Paediatric Haematology/Oncology Service, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Andres Morales
- Neuro Oncology Unit Department of Pediatric Hematology, Oncology and Stem Cell Transplantation St Joan de Déu Children′s Hospital, Barcelona, Spain
| | - Vicente Santa-Maria
- Neuro Oncology Unit Department of Pediatric Hematology, Oncology and Stem Cell Transplantation St Joan de Déu Children′s Hospital, Barcelona, Spain
| | | | - Ute Bartels
- The Hospital for Sick Children, Toronto, ON, Canada
| | | | | | - Christelle Dufour
- Département de Cancérologie de l’Enfant et de l’Adolescent, Institut Gustave Roussy, Villejuif, Paris, France
| | - Franck Bourdeaut
- PSL Research University, Institut Curie Research Center, Paris, France
| | | | - Eric Bouffet
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Annie Huang
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
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23
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Popovski D, Yao F, Bondoc A, Al-Karmi S, Ho B, Lindsay H, Li XN, Rutka J, Huang A. TBIO-02. IMMUNE PROFILING OF RARE EMBRYONAL BRAIN TUMORS REVEAL EVIDENCE OF DYSREGULATED INTERFERON SIGNALLING AS A POTENTIAL DETERMINANT OF IMMUNOLOGICAL HETEROGENEITY. Neuro Oncol 2020. [PMCID: PMC7715316 DOI: 10.1093/neuonc/noaa222.831] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Embryonal brain tumors (EBTs) remain the most common malignant pediatric brain tumors. Despite recent advances and improved understanding of the molecular biology of EBTs, clinical outcomes remain poor for rare EBTs. Previous large-scale genomic studies of rare EBTs have shed light on distinct genomic, transcriptomic and epigenomic profiles. Interestingly, these studies have revealed prominent tumor heterogeneity that provides opportunity to develop novel treatment strategies to improve patient outcomes. To examine the tumor microenvironment and identify tumor- specific biological dependencies, we performed deconvolution analysis of bulk gene expression (171 RNA-seq, 236 microarrays) and 586 methylation arrays, which revealed significant intra and inter-tumoral heterogeneity and implicated interferon (IFN)-mediated signalling as a determinant of a distinct immunological profile in rare EBTs. To further elucidate the importance of IFN signalling, we performed scRNA-seq on 20 primary samples, which provided evidence of a spectrum of IFN-immunological responses that vary from immunosuppressive to immunologically exhaustive that occur in a host dependent manner. To further validate our findings, we utilised a genetically engineered murine model of Atypical Teratoid Rhabdoid Tumor and primary xenografts in humanised mice to corroborate our in-silico profiles in vivo. Through amalgamation of our in-silico data with our in vivo data, we have identified evidence that dysregulated IFN responses represent a core element of the immunological heterogeneity present within subsets of rare EBTs. An improved understanding of the immune milieu in rare EBTs will provide avenues to develop specific onco-immune targets to address this clinical need.
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Affiliation(s)
- Dean Popovski
- Arthur and Sonia Labatt Brain Tumour Centre, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Fupan Yao
- Arthur and Sonia Labatt Brain Tumour Centre, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Andrew Bondoc
- Arthur and Sonia Labatt Brain Tumour Centre, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Salma Al-Karmi
- Arthur and Sonia Labatt Brain Tumour Centre, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ben Ho
- Arthur and Sonia Labatt Brain Tumour Centre, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Holly Lindsay
- Department of Pediatrics, Division of Hematology and Oncology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA
| | - Xiao-Nan Li
- Department of Pediatrics, Division of Hematology and Oncology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - James Rutka
- Arthur and Sonia Labatt Brain Tumour Centre, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Annie Huang
- Arthur and Sonia Labatt Brain Tumour Centre, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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24
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Ho B, Arnoldo A, Zhong Y, Lu M, Torchia J, Yao F, Hawkins C, Huang A. ATRT-33. ENABLING RAPID CLASSIFICATION OF ATRT WITH NANOSTRING NCOUNTER PLATFORM. Neuro Oncol 2020. [PMCID: PMC7715558 DOI: 10.1093/neuonc/noaa222.031] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
In recent years, using gene expression and methylation array platform, multiple research groups have reported the presence of at least three major Atypical Teratoid Rhabdoid Tumor (ATRT) subtypes that exhibit distinct epigenetic, transcriptomic and clinical features. Yet, utilizing ATRT subtypes in a clinical setting remains challenging due to a lack of suitable biological markers, limited sample quantities and relatively high cost of current assays. To address this gap between research and clinical practice, we have designed an assay that utilizes a custom 35 signature genes panel for the NanoString nCounter System and have created a flexible machine learning classifier package for ATRT tumour subtyping. We have analyzed 71 ATRT primary tumours with matching gene expression data using the 35 genes panel. 60% of the data was used for models training (10 repeats of 10-fold cross validation with subgroup balanced sample splitting) resulting in overall 94.6% training accuracy. The remaining 40% of the samples were used for model validation and the assay was able to achieve 92–100% accuracy with no subgroup bias. To demonstrate the flexibility of the workflow, we have tested it against other transcriptome-based methods such as gene expression array and RNASeq. We have also demonstrated its use in samples that were not classifiable by methylation-based method. We are presenting here a rapid and accurate ATRT subtyping assay for clinical usage that is compatible with archived ATRT tissues.
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Affiliation(s)
- Ben Ho
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Anthony Arnoldo
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, Toronto, ON, Canada
| | - Yvonne Zhong
- Division of Pathology, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Mei Lu
- Division of Hematology/Oncology, Dept, of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jonathon Torchia
- Genome Sequence Informatics, Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Fupan Yao
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Cynthia Hawkins
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Division of Pathology, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Annie Huang
- Division of Hematology/Oncology, Dept, of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
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25
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Ho B, Ellison J, Edwards N, Bates N. Prevalence of vitamin D analogue toxicity in dogs. Clin Exp Dermatol 2020; 46:577-578. [PMID: 33151582 DOI: 10.1111/ced.14499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- B Ho
- Dermatology Department, St George's Hospital, London, UK
| | - J Ellison
- Veterinary Poisons Information Service, London, UK
| | - N Edwards
- Veterinary Poisons Information Service, London, UK
| | - N Bates
- Veterinary Poisons Information Service, London, UK
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26
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Chow YF, Cheng BCP, Cheng HK, Ho B, Lee CK, Ng SK, So R, Tse KC, Tsui C, Wan R, Wong S. Hong Kong Society of Clinical Blood Management recommendations for implementation of patient blood management. Hong Kong Med J 2020; 26:331-338. [PMID: 32807736 DOI: 10.12809/hkmj208397] [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: 11/05/2022] Open
Abstract
Patient blood management (PBM) is a patient-centred, multidisciplinary approach to optimise red cell mass, minimise blood loss, and manage tolerance to anaemia in an effort to improve patient outcomes. Well-implemented PBM improves patient outcomes and reduces demand for blood products. The multidisciplinary approach of PBM can often allow patients to avoid blood transfusions, which are associated with less favourable clinical outcomes. In Hong Kong, there has been increasing demand for blood in the ageing population, and there are simultaneous blood safety and donor issues that are adversely affecting the blood supply. To address these challenges, the Hong Kong Society of Clinical Blood Management recommends implementation of a PBM programme in Hong Kong, including strategies such as optimising red blood cell mass, improving anaemia management, minimising blood loss, and rationalising the use of blood and blood products.
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Affiliation(s)
- Y F Chow
- Department of Anaesthesiology and OT Services, Queen Elizabeth Hospital, Hong Kong
| | - B C P Cheng
- Department of Anaesthesia and Operating Theatre Services, Tuen Mun Hospital, Hong Kong
| | - H K Cheng
- Department of Anaesthesia and Operating Theatre Services, Tseung Kwan O Hospital, Hong Kong
| | - B Ho
- Department of Anaesthesiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - S K Ng
- Private Practice, Hong Kong
| | - R So
- Department of Anaesthesia, Princess Margaret Hospital, Hong Kong
| | - K C Tse
- Department of Anaesthesia and Operating Theatre Services, Tseung Kwan O Hospital, Hong Kong
| | - C Tsui
- Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Hong Kong
| | - R Wan
- Private Practice, Hong Kong
| | - S Wong
- Department of Anaesthesiology and OT Services, Queen Elizabeth Hospital, Hong Kong
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27
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Reddy AT, Krailo MD, Buxton AB, Strother DR, Huang A, Zhou T, Judkins AR, Burger PC, Pollack IF, Williams-Hughes C, Fouladi M, Ho B, Mazewski CM, Lewis VA, Vezina LG, Booth TN, Mahajan A. Reply to S.A. Upadhyaya. J Clin Oncol 2020; 38:3353-3354. [PMID: 32730180 DOI: 10.1200/jco.20.01573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Alyssa T Reddy
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Mark D Krailo
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Allen B Buxton
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Douglas R Strother
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Annie Huang
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Tianni Zhou
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Alexander R Judkins
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Peter C Burger
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Ian F Pollack
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Chris Williams-Hughes
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Maryam Fouladi
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Ben Ho
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Claire M Mazewski
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Victor A Lewis
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Louis-Gilbert Vezina
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Timothy N Booth
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
| | - Anita Mahajan
- Alyssa T. Reddy, MD, University of California San Francisco, CA; Mark D. Krailo, PhD, Keck School of Medicine, University of Southern California, Los Angeles, CA; Allen B. Buxton, MS, Children's Oncology Group, Monrovia, CA; Douglas R. Strother, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Annie Huang, MD, PhD, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada; Tianni Zhou, PhD, California State University at Long Beach, Long Beach, CA; Alexander R. Judkins, MD, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA; Peter C. Burger, MD, Johns Hopkins University, Baltimore, MD; Ian F. Pollack, MD, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Chris Williams-Hughes, BS, Children's Oncology Group, Monrovia, CA; Maryam Fouladi, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Ben Ho, MSc, Hospital for Sick Children, Toronto, ON, Canada; Claire M. Mazewski, MD, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Victor A. Lewis, MD, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Louis-Gilbert Vezina, MD, The George Washington University School Medicine and Health Sciences, Washington, DC; Timothy N. Booth, MD, University of Texas Southwestern, Dallas, TX; and Anita Mahajan, MD, Mayo Clinic, Rochester, MN
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Gordon LE, Ho B. Injuries and illnesses among human remains detection-certified search-and-recovery dogs deployed to northern California in response to the Camp Fire wildfire of November 2018. J Am Vet Med Assoc 2020; 256:322-332. [PMID: 31961279 DOI: 10.2460/javma.256.3.322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To document injuries and illnesses incurred by search-and-recovery (S&R) dogs deployed to northern California in response to the Camp Fire wildfire of November 2018 and identify fire scene-specific hazards. ANIMALS 30 human remains detection-certified S&R dogs deployed to the Camp Fire scene. PROCEDURES Handlers of the S&R dogs completed a survey after deployment. Data on illnesses and injuries incurred by the dogs during deployment were summarized, incidence rates were calculated, and fire scene hazards were identified. RESULTS Dogs were deployed for 161 days in total, representing 121 operational search shifts that totalled 931 hours. Injuries and illnesses (ie, medical issues) were reported for 20 (67%) dogs. Wounds (lacerations and abrasions) were the most common injury, occurring in 13 (43%) dogs for an incidence rate of 34.4 wounds/1,000 h worked. The most common illness-related issues were weight loss and lethargy or fatigue, each reported for 3 (10%) dogs for an incidence rate of 3.2 events/1,000 h worked. Total incidence rate for all medical issue events was 67.7 events/1,000 h worked. Specific to the Camp Fire scene were respiratory hazards of carcinogenic woodland smoke, aerosolized dry ash, and poison oak fumes; and contact hazards of burning ground or roots, unstable sewer covers, prescription medications, unexploded ammunition, congealed vehicle battery acid, and antifreeze, all hidden under layers of ash. CONCLUSIONS AND CLINICAL RELEVANCE Lacerations, abrasions, weight loss, and lethargy or fatigue were common among the S&R dogs, and ash covering fire scene-specific hazards likely contributed. In addition to safety concerns common to all team personnel, hazards specific to S&R dogs in a postfire environment should be emphasized during hazmat and safety briefings, especially to handlers, search team managers, and medical personnel.
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M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Hung W, Chun S, Wong T, Tsang C, Ho B, Ng A, Tsu H, Lam W. Transrectal vs. transperineal prostate biopsy under local anaesthesia: Prospective comparative analysis of cancer detection, safety and tolerability using patient-reported outcome measures at a single centre. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34175-6] [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: 10/23/2022] Open
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Chung PED, Gendoo DMA, Ghanbari-Azarnier R, Liu JC, Jiang Z, Tsui J, Wang DY, Xiao X, Li B, Dubuc A, Shih D, Remke M, Ho B, Garzia L, Ben-David Y, Kang SG, Croul S, Haibe-Kains B, Huang A, Taylor MD, Zacksenhaus E. Modeling germline mutations in pineoblastoma uncovers lysosome disruption-based therapy. Nat Commun 2020; 11:1825. [PMID: 32286280 PMCID: PMC7156401 DOI: 10.1038/s41467-020-15585-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 03/13/2020] [Indexed: 12/19/2022] Open
Abstract
Pineoblastoma is a rare pediatric cancer induced by germline mutations in the tumor suppressors RB1 or DICER1. Presence of leptomeningeal metastases is indicative of poor prognosis. Here we report that inactivation of Rb plus p53 via a WAP-Cre transgene, commonly used to target the mammary gland during pregnancy, induces metastatic pineoblastoma resembling the human disease with 100% penetrance. A stabilizing mutation rather than deletion of p53 accelerates metastatic dissemination. Deletion of Dicer1 plus p53 via WAP-Cre also predisposes to pineoblastoma, albeit with lower penetrance. In silico analysis predicts tricyclic antidepressants such as nortriptyline as potential therapeutics for both pineoblastoma models. Nortriptyline disrupts the lysosome, leading to accumulation of non-functional autophagosome, cathepsin B release and pineoblastoma cell death. Nortriptyline further synergizes with the antineoplastic drug gemcitabine to effectively suppress pineoblastoma in our preclinical models, offering new modality for this lethal childhood malignancy.
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Affiliation(s)
- Philip E D Chung
- Toronto General Research Institute, University Health Network, 67 College Street, Toronto, ON, M5G 2M1, Canada.,Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Deena M A Gendoo
- Centre for Computational Biology, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Ronak Ghanbari-Azarnier
- Toronto General Research Institute, University Health Network, 67 College Street, Toronto, ON, M5G 2M1, Canada.,Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Jeff C Liu
- Toronto General Research Institute, University Health Network, 67 College Street, Toronto, ON, M5G 2M1, Canada
| | - Zhe Jiang
- Toronto General Research Institute, University Health Network, 67 College Street, Toronto, ON, M5G 2M1, Canada
| | - Jennifer Tsui
- Toronto General Research Institute, University Health Network, 67 College Street, Toronto, ON, M5G 2M1, Canada
| | - Dong-Yu Wang
- Toronto General Research Institute, University Health Network, 67 College Street, Toronto, ON, M5G 2M1, Canada
| | - Xiao Xiao
- Toronto General Research Institute, University Health Network, 67 College Street, Toronto, ON, M5G 2M1, Canada.,The Key laboratory of Chemistry for Natural Products of Guizhou Province and Chinese Academic of Sciences, Guiyang, Guizhou, 550014, China.,State Key Laboratory for Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang, 550025, China
| | - Bryan Li
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada.,State Key Laboratory for Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang, 550025, China
| | - Adrian Dubuc
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada.,Developmental & Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - David Shih
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada.,Developmental & Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Marc Remke
- Developmental & Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ben Ho
- Developmental & Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Livia Garzia
- Developmental & Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON, Canada.,Faculty of Medicine, department of surgery, McGill University, Quebec, Canada
| | - Yaacov Ben-David
- The Key laboratory of Chemistry for Natural Products of Guizhou Province and Chinese Academic of Sciences, Guiyang, Guizhou, 550014, China.,State Key Laboratory for Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang, 550025, China
| | - Seok-Gu Kang
- Neurosurgery, Brain Tumor Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sidney Croul
- Department of Pathology & Laboratory Medicine, Division of Anatomical Pathology, Dalhousie University, Halifax, Canada
| | - Benjamin Haibe-Kains
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada.,Vector Institute, and Ontario Institute For Cancer Research, Toronto, ON, Canada
| | - Annie Huang
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada.,State Key Laboratory for Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang, 550025, China
| | - Michael D Taylor
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada.,State Key Laboratory for Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang, 550025, China.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Eldad Zacksenhaus
- Toronto General Research Institute, University Health Network, 67 College Street, Toronto, ON, M5G 2M1, Canada. .,Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada. .,Department of Medicine, University of Toronto, Toronto, ON, Canada.
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Ho B, Bates N, Edwards N, Robinson N, Ellison J. Under‐recognised effects on our canine and feline companions with 5‐fluorouracil use. Br J Dermatol 2020; 182:819. [DOI: 10.1111/bjd.18693] [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: 11/29/2022]
Affiliation(s)
- B. Ho
- Dermatology Department St George's University Hospitals NHS Foundation Trust London U.K
| | - N. Bates
- Veterinary Poisons Information Service London U.K
| | - N. Edwards
- Veterinary Poisons Information Service London U.K
| | - N. Robinson
- Veterinary Poisons Information Service London U.K
| | - J. Ellison
- Veterinary Poisons Information Service London U.K
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Reddy AT, Strother DR, Judkins AR, Burger PC, Pollack IF, Krailo MD, Buxton AB, Williams-Hughes C, Fouladi M, Mahajan A, Merchant TE, Ho B, Mazewski CM, Lewis VA, Gajjar A, Vezina LG, Booth TN, Parsons KW, Poss VL, Zhou T, Biegel JA, Huang A. Efficacy of High-Dose Chemotherapy and Three-Dimensional Conformal Radiation for Atypical Teratoid/Rhabdoid Tumor: A Report From the Children's Oncology Group Trial ACNS0333. J Clin Oncol 2020; 38:1175-1185. [PMID: 32105509 DOI: 10.1200/jco.19.01776] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Atypical teratoid/rhabdoid tumor (AT/RT) is an aggressive, early-childhood brain tumor without standard effective treatment. To our knowledge, we conducted the first AT/RT-specific cooperative group trial, ACNS0333, to examine the efficacy and safety of intensive postoperative chemotherapy and focal radiation to treat AT/RT. PATIENTS AND METHODS Patients from birth to 22 years of age with AT/RT were eligible. After surgery, they received 2 courses of multiagent chemotherapy, followed by 3 courses of high-dose chemotherapy with peripheral blood stem cell rescue and involved-field radiation therapy. Timing of radiation was based on patient age and disease location and extent. Central testing of tumor and blood for SMARCB1 status was mandated. Tumor molecular subclassification was performed retrospectively. The primary analysis was event-free survival (EFS) for patients < 36 months of age compared with a cooperative groups' historical cohort. Although accrual was based on the therapeutic question, potential prognostic factors, including age, tumor location, M stage, surgical resection, order of therapy, germline status, and molecular subtype, were explored. RESULTS Of 65 evaluable patients, 54 were < 36 months of age. ACNS0333 therapy significantly reduced the risk of EFS events in patients < 36 months of age compared with the historical cohort (P < .0005; hazard rate, 0.43; 95% CI, 0.28 to 0.66). Four-year EFS and overall survival for the entire cohort were 37% (95% CI, 25% to 49%) and 43% (95% CI, 31% to 55%), respectively. Timing of radiation did not affect survival, and 91% of relapses occurred by 2 years from enrollment. Treatment-related deaths occurred in 4 patients. CONCLUSION The ACNS0333 regimen dramatically improved survival compared with historical therapies for patients with AT/RT. Clinical characteristics and molecular subgrouping suggest prognostic differences. ACNS0333 results lay a foundation on which to build future studies and incorporate testing of new therapeutic agents.
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Affiliation(s)
- Alyssa T Reddy
- Departments of Neurology and Pediatrics, University of California San Francisco, San Francisco, CA
| | - Douglas R Strother
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alexander R Judkins
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Peter C Burger
- Department of Pathology, Johns Hopkins University, Baltimore, MD
| | - Ian F Pollack
- Department Neurosurgery, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Mark D Krailo
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | | | | | - Maryam Fouladi
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Anita Mahajan
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - Thomas E Merchant
- Department of Radiation Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Ben Ho
- Department of Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Claire M Mazewski
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Victor A Lewis
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amar Gajjar
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Louis-Gilbert Vezina
- Department of Radiology, The George Washington University School Medicine and Health Sciences, Washington, DC
| | - Timothy N Booth
- Department of Radiology, University of Texas Southwestern, Dallas, TX
| | | | - Vicky L Poss
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
| | - Tianni Zhou
- Department of Mathematics and Statistics, California State University at Long Beach, Long Beach, CA
| | - Jaclyn A Biegel
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Annie Huang
- Department of Pediatrics, Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Ontario, Canada
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Lambo S, Gröbner SN, Rausch T, Waszak SM, Schmidt C, Gorthi A, Romero JC, Mauermann M, Brabetz S, Krausert S, Buchhalter I, Koster J, Zwijnenburg DA, Sill M, Hübner JM, Mack N, Schwalm B, Ryzhova M, Hovestadt V, Papillon-Cavanagh S, Chan JA, Landgraf P, Ho B, Milde T, Witt O, Ecker J, Sahm F, Sumerauer D, Ellison DW, Orr BA, Darabi A, Haberler C, Figarella-Branger D, Wesseling P, Schittenhelm J, Remke M, Taylor MD, Gil-da-Costa MJ, Łastowska M, Grajkowska W, Hasselblatt M, Hauser P, Pietsch T, Uro-Coste E, Bourdeaut F, Masliah-Planchon J, Rigau V, Alexandrescu S, Wolf S, Li XN, Schüller U, Snuderl M, Karajannis MA, Giangaspero F, Jabado N, von Deimling A, Jones DTW, Korbel JO, von Hoff K, Lichter P, Huang A, Bishop AJR, Pfister SM, Korshunov A, Kool M. The molecular landscape of ETMR at diagnosis and relapse. Nature 2019; 576:274-280. [PMID: 31802000 PMCID: PMC6908757 DOI: 10.1038/s41586-019-1815-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 10/16/2019] [Indexed: 12/18/2022]
Abstract
Embryonal tumours with multilayered rosettes (ETMRs) are aggressive paediatric embryonal brain tumours with a universally poor prognosis1. Here we collected 193 primary ETMRs and 23 matched relapse samples to investigate the genomic landscape of this distinct tumour type. We found that patients with tumours in which the proposed driver C19MC2-4 was not amplified frequently had germline mutations in DICER1 or other microRNA-related aberrations such as somatic amplification of miR-17-92 (also known as MIR17HG). Whole-genome sequencing revealed that tumours had an overall low recurrence of single-nucleotide variants (SNVs), but showed prevalent genomic instability caused by widespread occurrence of R-loop structures. We show that R-loop-associated chromosomal instability can be induced by the loss of DICER1 function. Comparison of primary tumours and matched relapse samples showed a strong conservation of structural variants, but low conservation of SNVs. Moreover, many newly acquired SNVs are associated with a mutational signature related to cisplatin treatment. Finally, we show that targeting R-loops with topoisomerase and PARP inhibitors might be an effective treatment strategy for this deadly disease.
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Affiliation(s)
- Sander Lambo
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Susanne N Gröbner
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tobias Rausch
- European Molecular Biology Laboratory (EMBL), Genome Biology Unit, Heidelberg, Germany
| | - Sebastian M Waszak
- European Molecular Biology Laboratory (EMBL), Genome Biology Unit, Heidelberg, Germany
| | - Christin Schmidt
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Aparna Gorthi
- Department of Cell Systems and Anatomy, University of Texas Health at San Antonio, San Antonio, TX, USA
- Greehey Children's Cancer Research Institute, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - July Carolina Romero
- Department of Cell Systems and Anatomy, University of Texas Health at San Antonio, San Antonio, TX, USA
- Greehey Children's Cancer Research Institute, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Monika Mauermann
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sebastian Brabetz
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sonja Krausert
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ivo Buchhalter
- Omics IT and Data Management Core Facility, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jan Koster
- Department of Oncogenomics, Academic Medical Center, Amsterdam, The Netherlands
| | - Danny A Zwijnenburg
- Department of Oncogenomics, Academic Medical Center, Amsterdam, The Netherlands
| | - Martin Sill
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jens-Martin Hübner
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Norman Mack
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Benjamin Schwalm
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marina Ryzhova
- Department of Neuropathology, NN Burdenko Neurosurgical Institute, Moscow, Russia
| | - Volker Hovestadt
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Simon Papillon-Cavanagh
- Department of Pediatrics, McGill University Health Center, McGill University, Montreal, Quebec, Canada
| | - Jennifer A Chan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Pablo Landgraf
- Department of Pediatrics, Pediatric Oncology and Hematology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ben Ho
- Division of Hematology/Oncology Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Till Milde
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Olaf Witt
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jonas Ecker
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix Sahm
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David Sumerauer
- Department of Pediatric Hematology and Oncology, University Hospital Motol, Prague, Czech Republic
| | - David W Ellison
- Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Brent A Orr
- Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Anna Darabi
- Department of Clinical Sciences Lund, Section of Neurosurgery, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Dominique Figarella-Branger
- Aix-Marseille University, Neurophysiopathology Institute (INP), CNRS, Marseille, France
- Department of Pathology, APHM, Marseille, France
| | - Pieter Wesseling
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pathology, Amsterdam University Medical Centers/location VUmc, Amsterdam, The Netherlands
| | - Jens Schittenhelm
- Department of Neuropathology, Institute of Pathology and Neuropathology, University Hospital of Tübingen, Tübingen, Germany
- Center for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital of Tübingen, Tübingen, Germany
| | - Marc Remke
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
- Division of Neurosurgery, Arthur and Sonia Labatt Brain Tumor Research Center, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Michael D Taylor
- Division of Neurosurgery, Arthur and Sonia Labatt Brain Tumor Research Center, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Maria J Gil-da-Costa
- Pediatric Hematology and Oncology Division, University Hospital São João Alameda Hernani Monteiro, Porto, Portugal
| | - Maria Łastowska
- Department of Pathology, Children's Memorial Health Institute, Warsaw, Poland
| | - Wiesława Grajkowska
- Department of Pathology, Children's Memorial Health Institute, Warsaw, Poland
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Peter Hauser
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Torsten Pietsch
- Institute of Neuropathology, Brain Tumor Reference Center of the German Society of Neuropathology and Neuroanatomy, University of Bonn Medical Center, Bonn, Germany
| | - Emmanuelle Uro-Coste
- Department of Pathology, Toulouse University Hospital, Toulouse, France
- INSERM U1037, Cancer Research Center of Toulouse (CRCT), Toulouse, France
| | - Franck Bourdeaut
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Paris Sciences Lettres Research University, Curie Institute, Paris, France
| | - Julien Masliah-Planchon
- Pediatric Oncology Department, SIREDO Pediatric Oncology Centre, Curie Institute, Paris, France
- Paris Sciences et Lettres Research University, Institut Curie Hospital, Laboratory of Somatic Genetics, Paris, France
| | - Valérie Rigau
- Department of Pathology, Montpellier University Medical Center, Montpellier, France
- Institute for Neuroscience of Montpellier (INM), INSERM U1051, Montpellier University Hospital, Montpellier, France
| | - Sanda Alexandrescu
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephan Wolf
- Genomics and Proteomics Core Facility, High Throughput Sequencing Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Xiao-Nan Li
- Brain Tumor Program, Texas Children's Cancer Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ulrich Schüller
- Institute of Neuropathology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
- Research Institute Children's Cancer Center, Hamburg, Germany
- Department of Pediatric Hematology and Oncology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Matija Snuderl
- Department of Pathology, NYU Langone Health, New York, NY, USA
| | - Matthias A Karajannis
- Division of Pediatric Hematology/Oncology, NYU Langone Medical Center, The Stephen D. Hassenfeld Children's Center for Cancer and Blood Disorders, New York, NY, USA
| | - Felice Giangaspero
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed-Mediterranean Neurological Institute, Pozzilli, Italy
| | - Nada Jabado
- Department of Pediatrics, McGill University Health Center, McGill University, Montreal, Quebec, Canada
| | - Andreas von Deimling
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David T W Jones
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jan O Korbel
- European Molecular Biology Laboratory (EMBL), Genome Biology Unit, Heidelberg, Germany
| | - Katja von Hoff
- Department of Pediatric Oncology/Hematology, Charité University Medicine, Berlin, Germany
- Department for Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Lichter
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annie Huang
- Division of Hematology/Oncology Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Medical Biophysics, Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Alexander J R Bishop
- Department of Cell Systems and Anatomy, University of Texas Health at San Antonio, San Antonio, TX, USA
- Greehey Children's Cancer Research Institute, University of Texas Health at San Antonio, San Antonio, TX, USA
- Mays Cancer Center, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Stefan M Pfister
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Andrey Korshunov
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marcel Kool
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
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35
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Li B, Vasiljevic A, Dufour C, Ho B, Hwang E, Gururangan S, Hansford J, Laquerriere A, Delisle MB, Fangusaro J, Forest F, Sumihito N, Toledano H, Birks D, Fan X, Fouladi M, Gajjar A, Gauchotte G, Hoffman L, Jones C, Loussouarn D, Mokhtari K, Pomeroy S, Rousseau A, Somers G, Taylor M, Ziegler DS, Lu M, Hawkins C, Grundy R, Jouvet A, Bouffet E, Ashley Hill D, Huang A. PDTM-24. PINEOBLASTOMA SEGREGATES INTO MOLECULAR SUBTYPES WITH DISTINCT CLINICOPATHOLOGIC FEATURES: REPORT FROM THE RARE BRAIN TUMOUR CONSORTIUM. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz175.800] [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: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Pineoblastoma (PB) is a rare but aggressive pediatric brain tumour arising from the pineal gland. Overall survival rates are estimated at 50–70%, with younger patients (< 5 years old) faring much worse (15–40%) despite intensive treatment regimens. Although germline RB1 and DICER1 alterations have been reported in a small proportion of PB, the clinical significance of such alterations and the biology of sporadic cases remains unknown.
METHODS
We collected tumor tissue from 93 PB cases diagnosed at their referring centres. We undertook global DNA methylation profiling and performed multiple orthogonal consensus clustering analyses to elucidate PB subgroups. Chromosomal copy number alterations were determined using Conumee and GISTIC2, and whole exome or targeted sequencing was completed. Clinical data was analyzed with correlative statistical methods and outcomes were measured by Kaplan-Meier survival estimates.
RESULTS
PB comprise five epigenetic groups, designated 1, 2, 3, 4A, and 4B. Deleterious, mutually exclusive alterations affecting miRNA biogenesis pathway members (DICER1, DROSHA, and DGCR8) were observed in 12/21 group 1 and 11/11 group 2 samples. Group 4A was characterized by recurrent RB1 loss and gain of the oncogenic miR-17/92, and group 4B by recurrent gain or amplification of MYC. These groups also exhibit distinct clinical features. PB groups 1–3 arose in older children (median ages 5.2–14.0 years) and had intermediate to excellent outcome (5-year OS of 71.9–100%). Group 4A and 4B were restricted to much younger children (median age 1.3–1.4 years) and had dismal prognoses (5-year OS 37.5% and 28.6%, respectively).
CONCLUSIONS
PB divides into five groups with distinct genetic and clinical profiles. These findings will have important implications for precise patient stratification and form the foundation for preclinical studies of biology-informed therapies.
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Affiliation(s)
- Bryan Li
- Hospital for Sick Children, Toronto, ON, Canada
| | | | | | - Ben Ho
- Hospital for Sick Children, Toronto, ON, Canada
| | - Eugene Hwang
- Children’s National Medical Center, Washington, DC, USA
| | - Sridharan Gururangan
- Preston A. Wells Jr Center for Brain Tumor Therapy at the University of Florida, Gainesville, FL, USA
| | - Jordan Hansford
- Children’s Cancer Centre, Royal Children’s Hospital, Melbourne, Australia
| | | | | | - Jason Fangusaro
- Division of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Fabien Forest
- Department of Pathology, CHU St. Etienne, France, Saint-Étienne, France
| | - Nobusawa Sumihito
- Gunma University, Aramaki-machi, Maebashi City, Gunma Prefecture, Japan, Maebashi City, Japan
| | - Helen Toledano
- Department of Pediatric Hematology Oncology, Children’s Medical Center of Israel, Petach Tikva, Israel
| | - Diane Birks
- Department of Pediatrics, University of Colorado Denver, Denver, Colorado, USA
| | - Xing Fan
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
| | | | - Amar Gajjar
- St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | | | | | | | - Karima Mokhtari
- Hôpital Universitaire Pitie-Salpetriere, France, Paris, France
| | | | | | - Gino Somers
- The Hospital for Sick Children, Toronto, ON, Canada
| | | | | | | | | | | | | | - Eric Bouffet
- The Hospital for Sick Children, Toronto, ON, Canada
| | - D Ashley Hill
- Division of Pathology, Children’s National Medical Center, Washington DC, USA
| | - Annie Huang
- The Hospital for Sick Children, Toronto, ON, Canada
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36
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Sin-Chan P, Mumal I, Suwal T, Ho B, Fan X, Singh I, Du Y, Lu M, Patel N, Torchia J, Popovski D, Fouladi M, Guilhamon P, Hansford JR, Leary S, Hoffman LM, Mulcahy Levy JM, Lassaletta A, Solano-Paez P, Rivas E, Reddy A, Gillespie GY, Gupta N, Van Meter TE, Nakamura H, Wong TT, Ra YS, Kim SK, Massimi L, Grundy RG, Fangusaro J, Johnston D, Chan J, Lafay-Cousin L, Hwang EI, Wang Y, Catchpoole D, Michaud J, Ellezam B, Ramanujachar R, Lindsay H, Taylor MD, Hawkins CE, Bouffet E, Jabado N, Singh SK, Kleinman CL, Barsyte-Lovejoy D, Li XN, Dirks PB, Lin CY, Mack SC, Rich JN, Huang A. A C19MC-LIN28A-MYCN Oncogenic Circuit Driven by Hijacked Super-enhancers Is a Distinct Therapeutic Vulnerability in ETMRs: A Lethal Brain Tumor. Cancer Cell 2019; 36:51-67.e7. [PMID: 31287992 DOI: 10.1016/j.ccell.2019.06.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/26/2019] [Accepted: 06/03/2019] [Indexed: 12/26/2022]
Abstract
Embryonal tumors with multilayered rosettes (ETMRs) are highly lethal infant brain cancers with characteristic amplification of Chr19q13.41 miRNA cluster (C19MC) and enrichment of pluripotency factor LIN28A. Here we investigated C19MC oncogenic mechanisms and discovered a C19MC-LIN28A-MYCN circuit fueled by multiple complex regulatory loops including an MYCN core transcriptional network and super-enhancers resulting from long-range MYCN DNA interactions and C19MC gene fusions. Our data show that this powerful oncogenic circuit, which entraps an early neural lineage network, is potently abrogated by bromodomain inhibitor JQ1, leading to ETMR cell death.
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MESH Headings
- Biomarkers, Tumor
- Brain Neoplasms/diagnosis
- Brain Neoplasms/etiology
- Brain Neoplasms/therapy
- Cell Cycle/genetics
- Cell Transformation, Neoplastic/drug effects
- Cell Transformation, Neoplastic/genetics
- Chromosomes, Human, Pair 19
- Chromosomes, Human, Pair 2
- DNA Copy Number Variations
- Enhancer Elements, Genetic
- Epigenesis, Genetic
- Gene Expression Regulation
- Gene Regulatory Networks
- Genetic Association Studies
- Genetic Predisposition to Disease
- Humans
- MicroRNAs/genetics
- Models, Biological
- Multigene Family
- N-Myc Proto-Oncogene Protein/genetics
- Neoplasms, Germ Cell and Embryonal/diagnosis
- Neoplasms, Germ Cell and Embryonal/etiology
- Neoplasms, Germ Cell and Embryonal/therapy
- Oncogenes
- RNA-Binding Proteins/genetics
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Affiliation(s)
- Patrick Sin-Chan
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON M5G0A4, Canada
| | - Iqra Mumal
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON M5G0A4, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S1A8, Canada
| | - Tannu Suwal
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON M5G0A4, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S1A8, Canada
| | - Ben Ho
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON M5G0A4, Canada
| | - Xiaolian Fan
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON M5G0A4, Canada
| | - Irtisha Singh
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Yuchen Du
- Department of Pediatrics, Division of Hematology and Oncology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA
| | - Mei Lu
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON M5G0A4, Canada
| | - Neilket Patel
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON M5G0A4, Canada
| | - Jonathon Torchia
- Princess Margaret Cancer Center-OICR Translational Genomics Laboratory, Ontario Institute for Cancer Research, Toronto, ON M5G0A3, Canada
| | - Dean Popovski
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON M5G0A4, Canada
| | - Maryam Fouladi
- Division of Oncology, Department of Cancer and Blood Diseases, Cincinnati Children's Hospital, Cincinnati, OH 45229, USA
| | - Paul Guilhamon
- Developmental and Stem Cell Biology Program and Arthur and Sonia Labatt Brain Tumor Research Centre, The Hospital for Sick Children, Toronto, ON M5G0A4, Canada
| | - Jordan R Hansford
- Children's Cancer Centre, Royal Children's Hospital, Murdoch Children's Research Institute, Department of Pediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Sarah Leary
- Department of Hematology-Oncology, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Lindsey M Hoffman
- Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045, USA
| | - Jean M Mulcahy Levy
- Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045, USA
| | - Alvaro Lassaletta
- Pediatric Hematology and Oncology Department, Hospital Infantil Universitario Niño Jesús, Madrid 28009, Spain
| | - Palma Solano-Paez
- Department of Pediatric Oncology, Hospital Infantil Virgen del Rocio, Seville 41013, Spain
| | - Eloy Rivas
- Department of Pathology, Neuropathology Division, Hospital Universitario Virgen del Rocio, Seville 41013, Spain
| | - Alyssa Reddy
- University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - G Yancey Gillespie
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham AL 35294, USA
| | - Nalin Gupta
- Department of Neurological Surgery, University of California, San Francisco, CA 94143-0112, USA
| | - Timothy E Van Meter
- Department of Pediatrics, Virginia Commonwealth University, Richmond, VA 23298-0631, USA
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University, Fukuoka 830-0011, Japan
| | - Tai-Tong Wong
- Pediatric Brain Tumor Program, Taipei Cancer Center, Taipei Medical University, Taipei 11031, Taiwan
| | - Young-Shin Ra
- Department of Neurosurgery, Asan Medical Center, Seoul 138-736, Korea
| | - Seung-Ki Kim
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul 03080, Korea
| | - Luca Massimi
- Department of Neurosurgery, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Richard G Grundy
- Children's Brain Tumor Research Centre, Queen's Medical Centre University of Nottingham, Nottingham NG72UH, UK
| | - Jason Fangusaro
- Department of Pediatric Hematology and Oncology at Children's Healthcare of Atlanta and the Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Donna Johnston
- Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, ON K1H8L1, Canada
| | - Jennifer Chan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB T2N1N4, Canada
| | - Lucie Lafay-Cousin
- Department of Pediatric Oncology, Alberta Children's Hospital, Calgary, AB T3B6A8, Canada
| | - Eugene I Hwang
- Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC 20010, USA
| | - Yin Wang
- Department of Neuropathology Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Daniel Catchpoole
- The Tumor Bank, Children's Cancer Research Unit, Kids Research, the Children's Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Jean Michaud
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON K1H8M5, Canada
| | - Benjamin Ellezam
- Department of Pathology, CHU Sainte-Justine Research Center, Université de Montréal, Montréal, QC H3T1C5, Canada
| | - Ramya Ramanujachar
- Paediatric Haematology and Oncology, Southampton Children's Hospital, Southampton SO166YD, UK
| | - Holly Lindsay
- Department of Pediatrics, Division of Hematology and Oncology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA
| | - Michael D Taylor
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S1A8, Canada; Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Neurosurgery, Hospital for Sick Children, Toronto, ON M5G0A4, Canada
| | - Cynthia E Hawkins
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S1A8, Canada; Department of Pathology, The Hospital for Sick Children, Toronto, ON M5G1X8, Canada
| | - Eric Bouffet
- Division of Hematology-Oncology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON M5G0A4, Canada
| | - Nada Jabado
- Departments of Pediatrics and Human Genetics, McGill University, Montréal, QC H3A0C7, Canada
| | - Sheila K Singh
- McMaster Stem Cell and Cancer Research Institute, McMaster University, Hamilton, ON L8S4K1, Canada
| | - Claudia L Kleinman
- Departments of Pediatrics and Human Genetics, McGill University, Montréal, QC H3A0C7, Canada
| | | | - Xiao-Nan Li
- Department of Pediatrics, Division of Hematology and Oncology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Peter B Dirks
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S1A8, Canada; Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Neurosurgery, Hospital for Sick Children, Toronto, ON M5G0A4, Canada
| | - Charles Y Lin
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Stephen C Mack
- Department of Pediatrics, Division of Hematology and Oncology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA
| | - Jeremy N Rich
- Department of Medicine, Division of Regenerative Medicine, University of California, San Diego, CA 92093, USA
| | - Annie Huang
- Arthur and Sonia Labatt Brain Tumor Research Centre, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON M5G0A4, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S1A8, Canada; Division of Hematology-Oncology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON M5G0A4, Canada; Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON M5G1L7, Canada.
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37
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Wasim S, Suddaby JS, Parikh M, Leylachian S, Ho B, Guerin A, So J. Pain and gastrointestinal dysfunction are significant associations with psychiatric disorders in patients with Ehlers-Danlos syndrome and hypermobility spectrum disorders: a retrospective study. Rheumatol Int 2019; 39:1241-1248. [PMID: 30923956 DOI: 10.1007/s00296-019-04293-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/20/2019] [Indexed: 12/20/2022]
Abstract
In this retrospective study, we investigate the frequency and types of psychiatric disorders and their relationship to systemic manifestations in a cohort of 391 Ehlers-Danlos syndromes (EDS) and hypermobility spectrum disorder (HSD) patients based on the current 2017 International Classification of EDS diagnostic criteria. A detailed, systematic retrospective chart review was undertaken for patients assessed for HSD or EDS at two Canadian health centres. Patients were diagnosed according to the Villefranche criteria and reclassified for this study according to the 2017 International Classification of EDS. Data validation and statistical analyses were conducted. Psychiatric disorders were very common, with 49.4% of the total cohort affected; 28.9% reported multiple psychiatric diagnoses. Mood (34.5%) and somatoform (28.6%) disorders were most common. Interestingly, attention-deficit/hyperactivity disorder (ADHD) was significantly enriched in the HSD, but not EDS cohort (p = 0.0002, 95% CI 3.48-9.00) compared to the general population. There were no differences in the systemic associations with having psychiatric manifestations in the HSD compared to the EDS subsets. Muscle/body pain (OR 1.99) and gastrointestinal dysfunction (OR 2.07) were significantly associated with having mood disorders, and gastrointestinal dysfunction (OR 2.61) and nerve-related pain (OR 3.27) were associated with having somatoform disorders across the cohort. The common systemic associations with the presence of psychiatric manifestations in both HSD and EDS reaffirm that the conditions should be treated as a spectrum rather than as wholly separate entities, particularly with respect to psychiatric management. EDS and HSD patients share common psychiatric presentations, though ADHD is more common with HSD.
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Affiliation(s)
- S Wasim
- Fred A. Litwin Family Centre in Genetic Medicine, University Health Network and Mount Sinai Hospital, 60 Murray Street, Box 34, 3rd Floor, Room 400, Toronto, ON, M5T 3L9, Canada
| | - J S Suddaby
- Fred A. Litwin Family Centre in Genetic Medicine, University Health Network and Mount Sinai Hospital, 60 Murray Street, Box 34, 3rd Floor, Room 400, Toronto, ON, M5T 3L9, Canada
| | - M Parikh
- Fred A. Litwin Family Centre in Genetic Medicine, University Health Network and Mount Sinai Hospital, 60 Murray Street, Box 34, 3rd Floor, Room 400, Toronto, ON, M5T 3L9, Canada
| | - S Leylachian
- Fred A. Litwin Family Centre in Genetic Medicine, University Health Network and Mount Sinai Hospital, 60 Murray Street, Box 34, 3rd Floor, Room 400, Toronto, ON, M5T 3L9, Canada
| | - B Ho
- Fred A. Litwin Family Centre in Genetic Medicine, University Health Network and Mount Sinai Hospital, 60 Murray Street, Box 34, 3rd Floor, Room 400, Toronto, ON, M5T 3L9, Canada.,Department of Pediatrics, Division of Medical Genetics, Queen's University, Kingston, Canada
| | - A Guerin
- Department of Pediatrics, Division of Medical Genetics, Queen's University, Kingston, Canada
| | - J So
- Fred A. Litwin Family Centre in Genetic Medicine, University Health Network and Mount Sinai Hospital, 60 Murray Street, Box 34, 3rd Floor, Room 400, Toronto, ON, M5T 3L9, Canada. .,Centre for Addiction and Mental Health, Toronto, Canada. .,Departments of Medicine, Psychiatry, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
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38
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Ho B, Heelan K, Solman L, Jones R, Dua J, Ingram JR, Flohr C. A survey of the treatment and management of patients with severe chronic spontaneous urticaria. Clin Exp Dermatol 2018; 44:353-355. [PMID: 30294917 DOI: 10.1111/ced.13778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2018] [Indexed: 11/28/2022]
Affiliation(s)
- B Ho
- Dermatology Department, St. George's Hospital, London, UK
| | - K Heelan
- Dermatology Department, Royal Marsden Hospital, Fulham Road, London, UK
| | - L Solman
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, UK
| | - R Jones
- Dermatology Department, Edinburgh Royal Infirmary, Edinburgh, Scotland, UK
| | - J Dua
- Dermatology Department, Royal Berkshire Hospital, Reading, UK
| | - J R Ingram
- Division of Infection & Immunity, Cardiff University, Cardiff, Wales, UK
| | - C Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas, NHS Foundation Trust, London, UK
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Hasselblatt M, Johann PD, Ho B, Grabovska Y, Yao F, Bourdeaut F, Frühwald MC, Williamson D, Kool M, Huang A. ATRT-11. MOLECULAR SUBGROUPS OF ATYPICAL TERATOID/RHABDOID TUMOR (ATRT): TOWARDS A CONSENSUS. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Pascal D Johann
- Hopp-Children’s Cancer Center at the NCT Heidelberg, and Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), and German Cancer Consortium (DKTK)), Heidelberg, Germany
- Dept. of Pediatric Oncology and Hematology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ben Ho
- Labatt’s Brain Tumor Research Centre, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Yura Grabovska
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Fupan Yao
- Labatt’s Brain Tumor Research Centre, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
- Dept. of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Franck Bourdeaut
- Pediatric Care and Research Center, Institute Curie, Paris Sciences et Lettres Research University, Paris, France
| | - Michael C Frühwald
- Swabian Children’s Cancer Center, Children’s Hospital Augsburg, Augsburg, Germany
| | - Dan Williamson
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Marcel Kool
- Hopp-Children’s Cancer Center at the NCT Heidelberg, and Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), and German Cancer Consortium (DKTK)), Heidelberg, Germany
| | - Annie Huang
- Labatt’s Brain Tumor Research Centre, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
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40
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Fonseca A, Ho B, Torchia J, Leary S, Lu M, Sommers G, Gupta A, Grant R, Norman J, Lafay-Cousin L, Hawkins C, Bartels U, Bouffet E, Huang A. TBIO-30. MOLECULAR LANDSCAPE AND CLINICAL CORRELATIONS OF CNS SARCOMAS. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.718] [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)
| | - Ben Ho
- The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Sarah Leary
- Seattle Children’s Hospital, Seattle, WA, USA
| | - Mei Lu
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Gino Sommers
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Abha Gupta
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Ronald Grant
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Joe Norman
- The Hospital for Sick Children, Toronto, ON, Canada
| | | | | | - Ute Bartels
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Eric Bouffet
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Annie Huang
- The Hospital for Sick Children, Toronto, ON, Canada
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41
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Ho B, Fonseca A, Al-Karmi S, Margol A, Yao F, Cheng S, Grant R, Handsford J, Gupta A, Vasiljevic A, Pawel B, Jabado N, Hawkins C, Lafay-Cousin L, Judkins A, Bouffet E, Huang A. ATRT-40. IMPACT OF MOLECULAR SUBTYPES ON TREATMENT OUTCOMES IN RHABDOID TUMORS - A REPORT FROM THE RARE TUMOR CONSORTIUM. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.037] [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: 11/13/2022] Open
Affiliation(s)
- Ben Ho
- The Hospital for Sick Children, Toronto, ON, Canada
| | | | | | - Ashley Margol
- Children’s Hospital of Los Angeles, Los Angeles, CA, USA
| | - Fupan Yao
- The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Ronald Grant
- The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Abha Gupta
- The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Bruce Pawel
- Childrens Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | | | | | - Eric Bouffet
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Annie Huang
- The Hospital for Sick Children, Toronto, ON, Canada
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42
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Li B, Vasiljevic A, Ho B, Norman J, Lu M, Hwang E, Hansford J, Jouvet A, Laquerriere A, Delisle MB, Gururangan S, Fangusaro J, Forest F, Sumihito N, Toledano H, Birks D, Fan X, Fouladi M, Gajjar A, Gauchotte G, Hoffman L, Jones C, Loussouarn D, Mokhtari K, Pomeroy S, Rousseau A, Somers G, Taylor M, Ziegler D, Hawkins C, Bouffet E, Grundy R, Dufour C, Huang A. EMBR-17. PINEOBLASTOMA SEGREGATES INTO MOLECULAR SUBTYPES WITH DISTINCT CLINICOPATHOLOGIC FEATURES: REPORT FROM THE RARE BRAIN TUMOR CONSORTIUM. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.201] [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: 11/14/2022] Open
Affiliation(s)
- Bryan Li
- Arthur and Sonia Labatt Brain Tumour Research Centre, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Ben Ho
- Arthur and Sonia Labatt Brain Tumour Research Centre, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Joseph Norman
- Arthur and Sonia Labatt Brain Tumour Research Centre, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mei Lu
- Arthur and Sonia Labatt Brain Tumour Research Centre, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Eugene Hwang
- Department of Oncology, Children’s National Medical Center, Washington, DC, USA
| | - Jordan Hansford
- Children’s Cancer Centre, Royal Children’s Hospital, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - Anne Jouvet
- CHU de Lyon, Lyon, France
- Pathology & Molecular Biology, SFCE,,, France
| | | | | | - Sridharan Gururangan
- Lillian S. Well Dept of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Jason Fangusaro
- Division of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Fabien Forest
- Department of Pathology, CHU St. Etienne, Saint-Étienne, France
| | - Nobusawa Sumihito
- Department of Human Pathology, Gunma University, Japan, Aramaki-machi, Maebashi City, Gunma Prefecture, Japan
| | - Helen Toledano
- Department of Pediatric Hematology Oncology, Children’s Medical Center of Israel, Petah Tikva, Israel
| | - Diane Birks
- Department of Pediatrics, University of Colorado Denver, Denver, CO, USA
| | - Xing Fan
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
| | - Maryam Fouladi
- Division of Oncology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Amar Gajjar
- Department of Oncology, Division of Neuro-Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - Lindsey Hoffman
- Department of Pediatrics, University of Colorado Denver, Denver, CO, USA
| | - Chris Jones
- The Institute of Cancer Research, London, UK
| | - Delphine Loussouarn
- Service d’Anatomie et de Cytologie pathologiques, CHU Nantes, Nantes, France
| | - Karima Mokhtari
- Département de Neuropathologie, Hôpital Universitaire Pitie-Salpetriere, Paris, France
| | - Scott Pomeroy
- F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Boston, MA, USA
| | - Audrey Rousseau
- Département de Pathologie cellulaire et tissulaire, CHU d’Angers, Angers, France
| | - Gino Somers
- Arthur and Sonia Labatt Brain Tumour Research Centre, Division of Pathology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Michael Taylor
- Arthur and Sonia Labatt Brain Tumour Research Centre, Division of Neurosurgery, The Hospital for Sick Children, Toronto, ON, Canada
| | - David Ziegler
- Kids Cancer Centre, Sydney Children’s Hospital, Sydney, NSW, Australia
| | - Cynthia Hawkins
- Arthur and Sonia Labatt Brain Tumour Research Centre, Division of Pathology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Eric Bouffet
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Richard Grundy
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Christelle Dufour
- Département de Cancérologie de l’Enfant et de l’Adolescent, Institut Gustave Roussy, Villejuif, Paris, France
| | - Annie Huang
- Arthur and Sonia Labatt Brain Tumour Research Centre, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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43
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Ho B, De Paoli M. Use of Ultrasound-Guided Superficial Cervical Plexus Block for Pain Management in the Emergency Department. J Emerg Med 2018; 55:87-95. [PMID: 29858144 DOI: 10.1016/j.jemermed.2018.04.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Received: 10/27/2017] [Revised: 03/09/2018] [Accepted: 04/11/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although use of the superficial cervical plexus block (SCPB) by anesthesia for perioperative indications is well described, there is a paucity of research on use of SCPB in the emergency department (ED). OBJECTIVE This prospective observational study aims to prospectively characterize the feasibility, potential for efficacy, and safety of ultrasound-guided SCPB in a convenience sample of ED patients presenting with painful conditions of the "cape" distribution of the neck and shoulder. METHODS Data were gathered prospectively on a convenience sample of 27 patients presenting to a community ED with painful conditions involving the distribution of the SCPB: para-cervical muscle spasm/pain (n = 8), clavicle fractures (n = 7), acromioclavicular joint injuries (n = 3), radicular pain (n = 3), and rotator cuff disorders (n = 6). Pre- and post-block 11-point verbal numeric pain scores (VNPS) were recorded, as was the incidence of any immediate complications. A retrospective chart review looked for delayed complications in the 14-day post-block period. RESULTS The mean 11-point VNPS reduction was 5.4 points (62%). There were no early serious complications and one case each of self-limiting vocal hoarseness and asymptomatic hemi-diaphragmatic paresis. No delayed block-related complications were found. CONCLUSIONS While limited by the fact that this was a nonrandomized observational experience with no control group, our findings suggest that SCBP may be safe and have potential for efficacy, and warrants further evaluation in a randomized controlled trial.
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Affiliation(s)
- Ben Ho
- Emergency Department, Nanaimo Regional General Hospital, Nanaimo, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, Nanaimo, British Columbia, Canada
| | - Michael De Paoli
- Department of Family Medicine, University of British Columbia, Nanaimo, British Columbia, Canada
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44
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Li BK, Vasiljevic A, Ho B, Jouvet A, Hwang EI, Hansford JR, Laquerriere A, Delisle MB, Gururangan S, Fangusaro JR, Forest F, Sumihito N, Toledano H, Fouladi M, Gauchotte G, Ziegler DS, Bouffet E, Grundy RG, Dufour C, Huang AA. Genomic landscape of pineoblastoma. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.2028] [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: 11/20/2022] Open
Affiliation(s)
| | | | - Ben Ho
- Hospital for Sick Children, Toronto, ON, Canada
| | - Anne Jouvet
- Hopital Pierre Wertheimer, CHU Lyon, France, Lyon, France
| | | | - Jordan R. Hansford
- Children's Cancer Centre, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, Australia
| | | | | | - Sridharan Gururangan
- Preston Wells Center for Brain Tumor therapy, McKnight Brain Institute, University of Florida, Gainesville, FL
| | | | - Fabien Forest
- Department of Pathology, CHU St. Etienne, France, Saint-Etienne, France
| | - Nobusawa Sumihito
- Department of Human Pathology, Gunma University, Maebashi City, Japan
| | - Helen Toledano
- Department of Pediatric Hematology Oncology, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel
| | - Maryam Fouladi
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | | | - Eric Bouffet
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Richard G Grundy
- Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, United Kingdom
| | - Christelle Dufour
- Institut Gustave Roussy - Paediatric and Adolescent Oncology Department, Villejuif, France
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45
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Richardson EA, Ho B, Huang A. Atypical Teratoid Rhabdoid Tumour : From Tumours to Therapies. J Korean Neurosurg Soc 2018; 61:302-311. [PMID: 29742888 PMCID: PMC5957315 DOI: 10.3340/jkns.2018.0061] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 03/29/2018] [Accepted: 03/29/2018] [Indexed: 12/29/2022] Open
Abstract
Atypical teratoid rhabdoid tumours (ATRTs) are the most common malignant central nervous system tumours in children ≤1 year of age and represent approximately 1–2% of all pediatric brain tumours. ATRT is a primarily monogenic disease characterized by the bi-allelic loss of the SMARCB1 gene, which encodes the hSNF5 subunit of the SWI/SNF chromatin remodeling complex. Though conventional dose chemotherapy is not effective in most ATRT patients, high dose chemotherapy with autologous stem cell transplant, radiotherapy and/or intrathecal chemotherapy all show significant potential to improve patient survival. Recent epigenetic and transcriptional studies highlight three subgroups of ATRT, each with distinct clinical and molecular characteristics with corresponding therapeutic sensitivities, including epigenetic targeting, and inhibition of tyrosine kinases or growth/lineage specific pathways.
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Affiliation(s)
- Elizabeth Anne Richardson
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Canada.,Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Canada.,Department of Cell Biology, Hospital for Sick Children, Toronto, Canada
| | - Ben Ho
- Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Canada.,Department of Cell Biology, Hospital for Sick Children, Toronto, Canada
| | - Annie Huang
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Canada.,Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Canada.,Department of Cell Biology, Hospital for Sick Children, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada.,Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
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46
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Pollard CA, Burns DS, Ho B, Johnston AM. Meningoencephalitis in a Royal Marine after skinning reindeer in Norway. J ROY ARMY MED CORPS 2017; 164:117-119. [PMID: 29151040 DOI: 10.1136/jramc-2017-000848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 11/03/2022]
Abstract
Meningoencephalitis presenting in service personnel overseas may present a diagnostic challenge due to the broad range of potential differential diagnosis as well as the requirement for rapid assessment and treatment. A 25-year-old Royal Marine was evacuated to the Royal Centre for Defence Medicine in Birmingham, UK, with a history of rash consistent with erythema chronicum migrans, a seizure, and lymphocytic pleocytosis after skinning reindeer in Norway. Neuroborreliosis was suspected and empirical antibiotics were administered. Despite subsequent negative serology for Borrelia burgdorferi, given the clinical features and lymphocytic pleocytosis, an atypical presentation of neuroborreliosis remains a possible diagnosis in this scenario. This case serves to illustrate that British military personnel on exercise are potentially at risk of contracting borreliosis both in the UK and abroad, serological tests can be unreliable, and the differential diagnosis of meningoencephalitis can be broad with specialist input often required.
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Affiliation(s)
- Christopher A Pollard
- Department of Microbiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Department of Infection and Tropical Medicine, Heartlands Hospital, Birmingham, UK
| | - D S Burns
- Department of Infection and Tropical Medicine, Heartlands Hospital, Birmingham, UK
| | - B Ho
- Major Trauma Service, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - A McD Johnston
- Department of Anaesthesia and Intensive Care Medicine, Royal Centre for Defence Medicine, Birmingham, UK
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47
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Atiemo K, Skaro A, Maddur H, Zhao L, Montag S, VanWagner L, Goel S, Kho A, Ho B, Kang R, Holl JL, Abecassis MM, Levitsy J, Ladner DP. Mortality Risk Factors Among Patients With Cirrhosis and a Low Model for End-Stage Liver Disease Sodium Score (≤15): An Analysis of Liver Transplant Allocation Policy Using Aggregated Electronic Health Record Data. Am J Transplant 2017; 17:2410-2419. [PMID: 28226199 PMCID: PMC5769449 DOI: 10.1111/ajt.14239] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/07/2017] [Accepted: 02/12/2017] [Indexed: 01/25/2023]
Abstract
Although the Model for End-Stage Liver Disease sodium (MELD Na) score is now used for liver transplant allocation in the United States, mortality prediction may be underestimated by the score. Using aggregated electronic health record data from 7834 adult patients with cirrhosis, we determined whether the cause of cirrhosis or cirrhosis complications was associated with an increased risk of death among patients with a MELD Na score ≤15 and whether patients with the greatest risk of death could benefit from liver transplantation (LT). Over median follow-up of 2.3 years, 3715 patients had a maximum MELD Na score ≤15. Overall, 3.4% were waitlisted for LT. Severe hypoalbuminemia, hepatorenal syndrome, and hepatic hydrothorax conferred the greatest risk of death independent of MELD Na score with 1-year predicted mortality >14%. Approximately 10% possessed these risk factors. Of these high-risk patients, only 4% were waitlisted for LT, despite no difference in nonliver comorbidities between waitlisted patients and those not listed. In addition, risk factors for death among waitlisted patients were the same as those for patients not waitlisted, although the effect of malnutrition was significantly greater for waitlisted patients (hazard ratio 8.65 [95% CI 2.57-29.11] vs. 1.47 [95% CI 1.08-1.98]). Using the MELD Na score for allocation may continue to limit access to LT.
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Affiliation(s)
- K Atiemo
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - A Skaro
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - H Maddur
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Division of Hepatology, Department of Medicine
| | - L Zhao
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Department of Preventive Medicine, Feinberg School of Medicine
| | - S Montag
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Department of Preventive Medicine, Feinberg School of Medicine
| | - L VanWagner
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Division of Hepatology, Department of Medicine,Department of Preventive Medicine, Feinberg School of Medicine
| | - S Goel
- Center for Health Information Partnerships, Institute for Public Health and Medicine
| | - A Kho
- Center for Health Information Partnerships, Institute for Public Health and Medicine
| | - B Ho
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - R Kang
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Center for Healthcare Studies, Institute for Public Health and Medicine
| | - JL Holl
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Center for Healthcare Studies, Institute for Public Health and Medicine,Department of Pediatrics, Feinberg School of Medicine
| | - MM Abecassis
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - J Levitsy
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Division of Hepatology, Department of Medicine
| | - DP Ladner
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Center for Healthcare Studies, Institute for Public Health and Medicine
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48
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Lewis I, White KM, Ho B, Elliott B, Watson B. Insights into targeting young male drivers with anti-speeding advertising: An application of the Step approach to Message Design and Testing (SatMDT). Accid Anal Prev 2017; 103:129-142. [PMID: 28431345 DOI: 10.1016/j.aap.2017.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 03/10/2017] [Accepted: 04/07/2017] [Indexed: 06/07/2023]
Abstract
In Australia, young drivers aged 17-25 years comprise 13% of the population yet account for 22% of all road deaths with young males over-represented in such trauma. Speeding represents a major contributing factor and advertising campaigns have long focused on promoting anti-speeding messages in the effort to reduce drivers' speeds. Positioned within a larger program of research aimed at developing, piloting, and evaluating a range of theoretically-informed anti-speeding messages, the current study reports results relating to the final phase of the research, the evaluation. Six messages were devised in accordance with the guiding framework, the Step approach to Message Design and Testing ([SatMDT]; Lewis et al., 2016) and based on the findings emerging from earlier qualitative and quantitative studies within the program of research. N=938 licensed drivers (n=455 males, 48%) aged 17-62 years completed an online survey. To ensure a controlled test of the persuasiveness of the message content, the messages were presented in an audio-based format and thus were devoid of potential confounds, such as images. The messages sought to address a particular belief (i.e., behavioural, normative, control) and to focus either on emphasising the positive aspects which make speeding less likely or challenging the negative aspects which make speeding more likely. Thus, key to this evaluation was to test the persuasiveness of the message content in terms of the particular belief and focus it was addressing. Participants were randomly assigned to either the Control condition (i.e., no exposure to a message) or the Intervention condition (i.e., exposed to one of the six messages presented as an audio-recorded message within the survey). Persuasiveness was assessed via a range of outcome measures including both direct (i.e., third-person perceptions, message rejection) as well as indirect measures (i.e., intentions, willingness to speed). Age, gender, and message type were independent variables (IVs), together with issue involvement as a covariate (or IV) in the study's analyses. Overall, positive persuasive effects, and a relative absence of any negative, dissuasive effects, were found for two messages, Glass Cars and The Lift. These messages addressed the same salient belief, control beliefs, with the former emphasising the factors which discourage speeding and the latter message challenging those factors which encourage speeding. The implications of the findings are discussed in terms of the insights they offer for the key content of future anti-speeding messages.
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Affiliation(s)
- I Lewis
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety, Queensland(CARRS-Q), Victoria Park Road, Kelvin Grove, QLD, 4059, Australia; Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation (IHBI), Cnr Musk Avenue and Blamey Street, Kelvin Grove, QLD, 4059, Australia.
| | - K M White
- Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation (IHBI), Cnr Musk Avenue and Blamey Street, Kelvin Grove, QLD, 4059, Australia; Queensland University of Technology (QUT), School of Psychology & Counselling, Victoria Park Road, Kelvin Grove, Queensland (QLD), 4059, Australia
| | - B Ho
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety, Queensland(CARRS-Q), Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | | | - B Watson
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety, Queensland(CARRS-Q), Victoria Park Road, Kelvin Grove, QLD, 4059, Australia; Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation (IHBI), Cnr Musk Avenue and Blamey Street, Kelvin Grove, QLD, 4059, Australia; Global Road Safety Partnership, Chemin Des Crets, CH-1211 Geneva 19, Switzerland
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49
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Sidhu BK, Furness H, Ho B, Elliott B. 43EMOLLIENT PRESCRIBING IN ELDERLY INPATIENTS ON LONG STAY WARDS IN A TEACHING HOSPITAL. Age Ageing 2017. [DOI: 10.1093/ageing/afx055.43] [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: 11/14/2022] Open
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50
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Ho B, Skaro A, Montag S, Zhao L. Elementary, My Dear Watson-The Era of Natural Language Processing in Transplantation. Am J Transplant 2017; 17:595-596. [PMID: 27977903 DOI: 10.1111/ajt.14164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 12/03/2016] [Indexed: 01/25/2023]
Affiliation(s)
- B Ho
- Northwestern University Feinberg School of Medicine - Organ Transplantation, Chicago, IL
| | - A Skaro
- Department of Surgery, Western University, London, ON, Canada
| | - S Montag
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - L Zhao
- Department of Preventive Medicine, Northwestern University, Chicago, IL
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