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Mittal N, Davidson J, Martinez MF, Sanchez R, Sane N, Giordano L, Choi DK, Kent P, Dighe D, Iqbal A, Kiely C, Breen K, Quigley JG, Catchatourian R, Gitelis S, Schmidt ML. A Tri-Institutional Approach to Address Disparities in Children's Oncology Group Clinical Trial Accrual for Adolescents and Young Adults and Underrepresented Minorities. J Adolesc Young Adult Oncol 2019; 8:227-235. [DOI: 10.1089/jayao.2018.0119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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)
- Nupur Mittal
- Department of Pediatrics, Rush University Children's Hospital, Chicago, Illinois
| | - Jonathan Davidson
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| | - Mario F. Martinez
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| | - Reynaldo Sanchez
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| | - Nitin Sane
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| | - Lisa Giordano
- Department of Pediatrics, Rush University Children's Hospital, Chicago, Illinois
| | - Daniel K. Choi
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| | - Paul Kent
- Department of Pediatrics, Rush University Children's Hospital, Chicago, Illinois
| | - Dipti Dighe
- Department of Pediatrics, John. H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
| | - Asneha Iqbal
- Department of Pediatrics, John. H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
| | - Cathleen Kiely
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| | - Kathleen Breen
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| | - John G. Quigley
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| | - Rosalind Catchatourian
- Department of Pediatrics, John. H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
| | - Steven Gitelis
- Department of Pediatrics, Rush University Children's Hospital, Chicago, Illinois
| | - Mary Lou Schmidt
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
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Suh E, Owen ED, Reichek J, Roggenkamp B, Trosman JR, Henderson TO, Mittal N, Dighe D, Iqbal A, Berardi R, Choi DK, Pillay Smiley N, Hesko C, Canner JA, Stewart Z, Sanford SD, Weldon CB. “Getting to Know You and Your Child” screening questionnaire: Results from a Chicago pediatric collaborative. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.30_suppl.163] [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: 11/20/2022] Open
Abstract
163 Background: In 2012, a congressional symposium identified the need for services to address psychosocial issues of children with cancer. In 2013, the Institute of Medicine recommended supportive oncology services be initiated at cancer diagnosis. Chicago providers of pediatric cancer are collaborating to improve care for children with cancer and their families focusing on psychosocial stressors and quality of life. Methods: The collaborative conducted a structured review of tools: Psychosocial Assessment Tool (PAT), Social Work Assessment Tool (SWAT), National Comprehensive Cancer Network (NCCN) Problem List, and √IN; with input from providers on stressors throughout the care continuum. The resulting screening tool was created and piloted in English and Spanish at 7 pediatric cancer hospitals. Social workers (SW) informally reported assessment of its usefulness. Results: Parents (n = 85) completed “Getting to Know You and Your Child” screening tool which inquired about caregivers, siblings, child’s interests, school, SSI/SNAP, challenges, and cultural/religious preferences. Providers reported families found the tool useful “to think about support needs.” The tool assessed 12 psychosocial stressors; the mean per patient/family was 2.4 (range 0-11). Most frequent stressors included: lack of support from friends, family, community (29%), paying for food (26%), job flexibility (26%), paying for utilities (25%), medical costs (23%), emotional support for family (22%), school concerns (21%). All who reported temporary residence also reported difficulty paying for housing (p < 0.01). Ten SWs reported this screening tool generated new insight into family structures, identified stressors and informed resolution efforts. Provider recommended adjustments to the screening tool: simplify terms for siblings, hobbies and spiritual, add pet question. Conclusions: Pilot testing of a psychosocial screening tool for pediatric and adolescent oncology informed providers of patient/family needs in a standard manner. Six of the seven pilot sites are implementing this tool as a standard practice. Preliminary data suggests patients and providers find the screener easy to use and informative.
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Affiliation(s)
- Eugene Suh
- Loyola University Medical Center, Maywood, IL
| | | | - Jennifer Reichek
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | | | | | | | | | - Dipti Dighe
- John H. Stroger Jr. Hospital of Cook County, Chicago, IL
| | - Asneha Iqbal
- Cook County Health and Hospital System, Chicago, IL
| | | | | | | | - Caroline Hesko
- University of Chicago Comer Children's Hospital, Chicago, IL
| | | | - Zayda Stewart
- UI Health Pediatric Hematology/Oncology Division, Chicago, IL
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Wyrebek R, Mohammad A, Iqbal A, Dighe D, Giordano L. Treatment of metabolic abnormalities with rasburicase in a premature neonate. Arch Clin Cases 2018. [DOI: 10.22551/2018.19.0502.10125] [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: 11/25/2022] Open
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4
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Suh E, Owen ED, Reichek J, Roggenkamp B, Trosman JR, Henderson TO, Mittal N, Dighe D, Iqbal A, Berardi R, Choi DK, Pillay Smiley N, Hesko C, Canner JA, Stewart Z, Sanford SD, Weldon CB. “Getting to know you and your child” screening questionnaire: Results from a Chicago pediatric collaborative. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e22515] [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)
- Eugene Suh
- Loyola University Medical Center, Maywood, IL
| | | | - Jennifer Reichek
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | | | | | | | | | - Dipti Dighe
- John H. Stroger Jr. Hospital of Cook County, Chicago, IL
| | - Asneha Iqbal
- Cook County Health and Hospital System, Chicago, IL, US
| | | | | | | | - Caroline Hesko
- University of Chicago Comer Children's Hospital, Chicago, IL
| | | | - Zayda Stewart
- UI Health Pediatric Hematology/Oncology Division, Chicago, IL, US
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Weldon CB, Roggenkamp B, Owen ED, Reichek J, Stewart Z, Trosman JR, Dighe D, Iqbal A, Suh E, Berardi R, Ganesan R, Choi DK, Henderson TO. "Getting to know you and your child" screening questionnaire: Results from a Chicago-based collaborative. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.7_suppl.150] [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: 11/20/2022] Open
Abstract
150 Background: In 2013 the Institute of Medicine recommended that supportive oncology services be initiated at time of cancer diagnosis. Providers of pediatric cancer care in the Chicago metro area, supported by The Coleman Foundation, created and pilot tested a standard psycho-social stressors screening instrument for children with cancer and their families. Methods: The collaborative conducted structured review of tools: Psychosocial Assessment Tool (PAT), Social Work Assessment Tool (SWAT), National Comprehensive Cancer Network (NCCN) Problem List, and √IN; and collected input from social workers and oncology providers on stressors throughout the care continuum. The resulting tool was piloted in English and Spanish at 7 pediatric cancer hospitals. Providers qualitatively reported assessment of its usefulness. Results: Patients/family (n = 57) completed the “getting to know you and your child” instrument which inquired about caregivers, siblings, child’s likes/hobbies, school situation, SSI/SNAP, challenges, and cultural/religious preferences. Providers reported that almost all families found the tool useful “to think about support needs”; one said it was invasive. The tool assessed 12 psychosocial stressors; the mean per patient/family was 2.49 (range 0-11). The most frequent stressors were support from friends, family, community (30%), paying for food (26%), job flexibility (26%), school concerns (25%), emotional support for family (25%), and medical costs (23%). All who reported temporary housing also reported difficulty paying for a place to live (p < 0.0001). Providers reported that the standard tool generated new insight into family structures, challenges and needs informing resolution efforts. Provider recommended adjustments: simplify terms for siblings, hobbies and spiritual, adding question about pets in the home. Conclusions: Pilot testing of a psycho-social screening tool for pediatric and adolescent oncology informed providers of patient/family needs in a standard manner. Four of the seven sites involved in the pilot are now implementing this tool as a standard practice; the remaining sites are performing analyses on how to incorporate the tool into their care processes.
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Affiliation(s)
| | | | | | - Jennifer Reichek
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Zayda Stewart
- UI Health Pediatric Hematology/Oncology Division, Chicago, IL, US
| | | | - Dipti Dighe
- John H. Stroger Jr. Hospital of Cook County, Chicago, IL
| | - Asneha Iqbal
- Cook County Health and Hospital System, Chicago, IL, US
| | - Eugene Suh
- Loyola University Medical Center, Maywood, IL
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Reichek J, Weldon CB, Suh E, Trosman JR, Sanford SD, Dighe D, Berardi R, Downing K, Choi DK, Roggenkamp B, Pillay Smiley N, Brown M, Owen ED, Ganesan R. Areas for quality improvement in pediatric supportive oncology services. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.31_suppl.146] [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: 11/20/2022] Open
Abstract
146 Background: In 2013, the Institute of Medicine report recommended that supportive oncology services be initiated at time of diagnosis. Providers of pediatric cancer care in the Chicagoland community, supported by The Coleman Foundation, sought to define areas for quality improvement of supportive oncology delivery to children. Methods: Focus groups and surveys with clinicians providing pediatric cancer care and supportive services at 14 sites were used to prioritize areas needing improvement. Results: 100% (14/14) of sites participated. Of the eligible sites, 6 were pediatric cancer treatment sites and 8 cancer care community organizations. Sites demonstrated consistent agreement for 8 of the 12 areas of focus for improvement. Over 50% of sites reported areas of focus (table) as important or very important. Conclusions: Sites identified the need for quality improvement in delivery of psychosocial, survivorship and palliative care for pediatric cancer patients. Survey results demonstrate a need for collaboration and efforts to guide care delivery improvement across sites. [Table: see text]
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Affiliation(s)
- Jennifer Reichek
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | | | - Eugene Suh
- Loyola University Medical Center, Maywood, IL
| | | | | | - Dipti Dighe
- John H. Stroger Jr. Hospital of Cook County, Chicago, IL
| | | | - Kim Downing
- Greater Illinois Pediatric Palliative Coalition, Chicago, IL
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Giordano L, Akinyede O, Bhatt N, Dighe D, Iqbal A. Methotrexate-Induced Neurotoxicity in Hispanic Adolescents with High-Risk Acute Leukemia—A Case Series. J Adolesc Young Adult Oncol 2017; 6:494-498. [DOI: 10.1089/jayao.2016.0094] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Lisa Giordano
- Department of Pediatrics, Cook County Health and Hospitals System, Chicago, Illinois
| | - Oyinade Akinyede
- Department of Pediatrics, Cook County Health and Hospitals System, Chicago, Illinois
| | - Nidhi Bhatt
- Department of Pediatrics, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
| | - Dipti Dighe
- Department of Pediatrics, Cook County Health and Hospitals System, Chicago, Illinois
| | - Asneha Iqbal
- Department of Pediatrics, Cook County Health and Hospitals System, Chicago, Illinois
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Reichek J, Weldon CB, Ganesan R, Suh E, Dighe D, Trosman JR, Choi DK, Berardi R, Sanford SD, Downing K, Owen ED, Kim M, Boss K, Kniola A, Newmark M, Pillay Smiley N, Brown M. Areas for quality improvement in pediatric supportive oncology services. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e22022] [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: 11/20/2022] Open
Abstract
e22022 Background: In 2013, the Institute of Medicine report recommended that supportive oncology services be initiated at time of diagnosis. Providers of pediatric cancer care in the Chicagoland community, supported by The Coleman Foundation, sought to define areas for quality improvement of supportive oncology delivery to children. Methods: Focus groups and surveys with clinicians providing pediatric cancer care and supportive services at 14 sites were used to prioritize areas needing improvement. Results: 100% (14/14) of sites participated. Of the eligible sites, 6 were pediatric cancer treatment sites and 8 cancer care community organizations. Sites demonstrated consistent agreement for 8 of the 12 areas of focus for improvement. Over 50% of sites reported areas of focus (table) as important or very important. Conclusions: Sites identified the need for quality improvement in delivery of psychosocial, survivorship and palliative care for pediatric cancer patients. Survey results demonstrate a need for collaboration and efforts to guide care delivery improvement across sites. [Table: see text]
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Affiliation(s)
| | | | | | - Eugene Suh
- Loyola University Medical Center, Maywood, IL
| | - Dipti Dighe
- John H. Stroger, Jr. Hospital of Cook County, Chicago, IL
| | | | | | | | | | - Kim Downing
- Greater Illinois Pediatric Palliative Coalition, Chicago, IL
| | | | | | | | | | | | | | - Melanie Brown
- Comer Children's, University of Chicago, Chicago, IL
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Martinez MF, Sanchez R, Mittal N, Kent P, Kiely C, Breen K, Davidson J, Sane N, Thakkar A, Buraglio M, Tamulonis K, Dighe D, Giordano L, Choi DK, Ording J, Thomas P, Quigley JG, Catchatourian R, Gitelis S, Schmidt ML. Improved access to Children's Oncology Group (COG) clinical trials for under-represented minorities and adolescents and young adults (AYAs) through a novel tri-institutional program: addressing cancer disparities. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e18000] [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)
- Mario F Martinez
- University of Illinois at Chicago College of Medicine, Chicago, IL
| | - Reynaldo Sanchez
- University of Illinois at Chicago College of Medicine, Chicago, IL
| | | | - Paul Kent
- Rush University Medical Center, Chicago, IL
| | | | | | | | - Nitin Sane
- University of Illinois at Chicago, Chicago, IL
| | | | | | | | - Dipti Dighe
- John H. Stroger, Jr. Hospital of Cook County, Chicago, IL
| | - Lisa Giordano
- John H. Stroger, Jr. Hospital of Cook County, Chicago, IL
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Mittal N, Llanos-Chea A, Dighe D, Giordano L. A Teenaged Patient with Severe Asparaginase-Induced Hypertriglyceridemia Safely Re-Challenged During Primary and Relapse Therapy for Acute Lymphoblastic Leukemia. J Adolesc Young Adult Oncol 2014. [DOI: 10.1089/jayao.2013.0037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Nupur Mittal
- Division of Pediatric Hematology/Oncology, University of Illinois at Chicago, Chicago, Illinois
| | - Alejandro Llanos-Chea
- Department of Pediatrics, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois
| | - Dipti Dighe
- Department of Pediatrics, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois
| | - Lisa Giordano
- Department of Pediatrics, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois
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Al-Tahan A, Sarkis O, Harajly M, Baghdadi OK, Zibara K, Boulos F, Dighe D, Kregel S, Bazarbachi A, El-Sabban M, Skapek SX, Saab R. Retinoic acid fails to induce cell cycle arrest with myogenic differentiation in rhabdomyosarcoma. Pediatr Blood Cancer 2012; 58:877-84. [PMID: 21755593 DOI: 10.1002/pbc.23246] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 05/26/2011] [Indexed: 12/16/2022]
Abstract
BACKGROUND Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children. Current treatment strategies do not cure most children with recurrent or high-risk disease, underlying the need for novel therapeutic approaches. Retinoic acid has been shown to induce differentiation in a variety of cells including skeletal myoblasts and neuroblasts. In the setting of minimal residual disease, retinoic acid improves survival in neuroblastoma, another poorly differentiated childhood tumor. Whether such an approach is useful for rhabdomyosarcoma has not yet been investigated. Several in vitro studies have demonstrated an appreciable effect of retinoic acid on human RMS cellular proliferation and differentiation. PROCEDURE We assessed the efficacy of ATRA on rhabdomyosarcoma, in vitro and in vivo, using cell lines and xenografts. RESULTS ATRA slowed RMS cell proliferation, and promoted a more differentiated myogenic phenotype in both alveolar and embryonal RMS cell lines. Treatment of cultured murine myoblasts with retinoids increased Myogenin expression, but did not induce cell cycle arrest. Despite the favorable in vitro effects, ATRA failed to delay relapse of minimal residual disease using human RMS xenografts in immuno-suppressed NOD-SCID (NSG) mice. Interestingly, tumors that recurred after ATRA treatment showed evidence of enhanced muscle differentiation. CONCLUSION Our results indicate that ATRA could increase the expression of some genes associated with muscle differentiation in rhabdomyosarcoma cells, but there was no benefit of single-agent therapy in an MRD model, likely because cell cycle arrest was uncoupled from the pro-differentiation effects of retinoids.
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Affiliation(s)
- Alaa Al-Tahan
- Department of Pediatrics, American University of Beirut, Beirut, Lebanon
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