1
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Wiestler B, Bison B, Behrens L, Tüchert S, Metz M, Griessmair M, Jakob M, Schlegel PG, Binder V, von Luettichau I, Metzler M, Johann P, Hau P, Frühwald M. Human-Level Differentiation of Medulloblastoma from Pilocytic Astrocytoma: A Real-World Multicenter Pilot Study. Cancers (Basel) 2024; 16:1474. [PMID: 38672556 PMCID: PMC11048511 DOI: 10.3390/cancers16081474] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Medulloblastoma and pilocytic astrocytoma are the two most common pediatric brain tumors with overlapping imaging features. In this proof-of-concept study, we investigated using a deep learning classifier trained on a multicenter data set to differentiate these tumor types. We developed a patch-based 3D-DenseNet classifier, utilizing automated tumor segmentation. Given the heterogeneity of imaging data (and available sequences), we used all individually available preoperative imaging sequences to make the model robust to varying input. We compared the classifier to diagnostic assessments by five readers with varying experience in pediatric brain tumors. Overall, we included 195 preoperative MRIs from children with medulloblastoma (n = 69) or pilocytic astrocytoma (n = 126) across six university hospitals. In the 64-patient test set, the DenseNet classifier achieved a high AUC of 0.986, correctly predicting 62/64 (97%) diagnoses. It misclassified one case of each tumor type. Human reader accuracy ranged from 100% (expert neuroradiologist) to 80% (resident). The classifier performed significantly better than relatively inexperienced readers (p < 0.05) and was on par with pediatric neuro-oncology experts. Our proof-of-concept study demonstrates a deep learning model based on automated tumor segmentation that can reliably preoperatively differentiate between medulloblastoma and pilocytic astrocytoma, even in heterogeneous data.
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Affiliation(s)
- Benedikt Wiestler
- Department of Neuroradiology, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (M.G.)
- TranslaTUM, Center for Translational Cancer Research, Technical University of Munich, 81675 Munich, Germany
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
| | - Brigitte Bison
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University Hospital Augsburg, 86156 Augsburg, Germany; (B.B.); (L.B.)
- Neuroradiological Reference Center for the Pediatric Brain Tumor (HIT) Studies of the German Society of Pediatric Oncology and Hematology, Faculty of Medicine, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Lars Behrens
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University Hospital Augsburg, 86156 Augsburg, Germany; (B.B.); (L.B.)
- Neuroradiological Reference Center for the Pediatric Brain Tumor (HIT) Studies of the German Society of Pediatric Oncology and Hematology, Faculty of Medicine, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Stefanie Tüchert
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Marie Metz
- Department of Neuroradiology, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (M.G.)
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
| | - Michael Griessmair
- Department of Neuroradiology, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (M.G.)
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
| | - Marcus Jakob
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Regensburg, 93053 Regensburg, Germany;
| | - Paul-Gerhardt Schlegel
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Children’s Hospital Würzburg, 97080 Würzburg, Germany;
| | - Vera Binder
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Department of Pediatrics, Dr. Von Hauner Children’s Hospital, University Hospital, LMU Munich, 80539 Munich, Germany;
| | - Irene von Luettichau
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Kinderklinik München Schwabing, Children’s Cancer Research Center, TUM School of Medicine and Health, Technical University of Munich, 80333 Munich, Germany;
| | - Markus Metzler
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany;
| | - Pascal Johann
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Swabian Children’s Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, 86156 Augsburg, Germany; (P.J.); (M.F.)
| | - Peter Hau
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, University Hospital Regensburg, 93053 Regensburg, Germany;
| | - Michael Frühwald
- Study Groups on CNS Tumors Within the Bavarian Cancer Research Center (BZKF)
- KIONET, Kinderonkologisches Netzwerk Bayern
- Swabian Children’s Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, 86156 Augsburg, Germany; (P.J.); (M.F.)
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2
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Flaadt T, Wild H, Abele M, Frühwald M, Dirksen U, Classen CF, Seitz C, Redlich A, Lauer UM, Kloker L, Kratz C, Schneider DT, Brecht IB. NUT carcinoma in pediatric patients: Characteristics, therapeutic regimens, and outcomes of 11 cases registered with the German Registry for Rare Pediatric Tumors (STEP). Pediatr Blood Cancer 2024; 71:e30821. [PMID: 38148490 DOI: 10.1002/pbc.30821] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND AND AIMS Nuclear protein of the testis (NUT) carcinoma (NC) is a rare and highly aggressive tumor defined by the presence of a somatic NUTM1 rearrangement, occurring mainly in adolescents and young adults. We analyzed the clinical and biological features of German pediatric patients (≤18 years) with NC. METHODS This study describes the characteristics and outcome of 11 children with NC registered in the German Registry for Rare Pediatric Tumors (STEP). RESULTS Eleven patients with a median age of 13.2 years (range 6.6-17.8) were analyzed. Malignant misdiagnoses were made in three patients. Thoracic/mediastinal tumors were found to be the primary in six patients, head/neck in four cases; one patient had multifocal tumor with an unknown primary. All patients presented with regional lymph node involvement, eight patients (72.7%) with distant metastases. Seven patients underwent surgery, eight radiotherapy with curative intent; polychemotherapy was administered in all patients. Novel treatment strategies including immunotherapy, targeted therapies, and virotherapy were applied in three patients. Median event-free survival and overall survival were 1.5 and 6.5 months, respectively. CONCLUSIONS Every undifferentiated or poorly differentiated carcinoma should undergo testing for the specific rearrangement of NUTM1, in order to initiate an intense therapeutic regimen as early as possible. As in adults, only few pediatric patients with NC achieve prolonged survival. Thus, novel therapeutic strategies should be included and tested in clinical trials.
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Affiliation(s)
- Tim Flaadt
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tubingen, Germany
| | - Hannah Wild
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tubingen, Germany
| | - Michael Abele
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tubingen, Germany
| | - Michael Frühwald
- Swabian Children's Cancer Center, Children's Hospital, Klinikum Augsburg, Augsburg, Germany
| | - Uta Dirksen
- Pediatrics III, West German Cancer Centre Essen, German Cancer Consortium (DKTK) site Essen, National Center for Tumordiseases (NCT) site Essen, University Hospital Essen, Essen, Germany
| | - Carl F Classen
- Pediatric Haematology/Oncology/Immunology, Department of Pediatrics, University Hospital Rostock, Rostock, Germany
| | - Christian Seitz
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tubingen, Germany
| | - Antje Redlich
- Pediatric Oncology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Ulrich M Lauer
- Department of Internal Medicine VIII, Medical Oncology and Pneumology, University of Tuebingen, Tuebingen, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Partner Site Tuebingen, Tuebingen, Germany
| | - Linus Kloker
- Department of Internal Medicine VIII, Medical Oncology and Pneumology, University of Tuebingen, Tuebingen, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Partner Site Tuebingen, Tuebingen, Germany
| | - Christian Kratz
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | | | - Ines B Brecht
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tubingen, Germany
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3
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Feuchtinger T, Bader P, Subklewe M, Breidenbach M, Willier S, Metzler M, Gökbuget N, Hauer J, Müller F, Schlegel PG, Frühwald M, Schmid C, Troeger A, Baldus C, Meisel R, Künkele A, Topp M, Bourquin JP, Cario G, Von Stackelberg A, Peters C. Approaches for bridging therapy prior to chimeric antigen receptor T cells for relapsed/refractory acute lymphoblastic B-lineage leukaemia in children and young adults. Haematologica 2024. [PMID: 38356450 DOI: 10.3324/haematol.2023.283780] [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] [Received: 06/20/2023] [Indexed: 02/16/2024] Open
Abstract
The ongoing development of immunotherapies, including chimeric antigen receptor (CAR) T cells, has revolutionized cancer treatment. In paediatric relapsed/refractory B-lineage acute leukaemia antiCD19-CARs induced impressive initial response rates, with event-free survival plateauing at 30-50% in long-term follow-up data. During the interval between diagnosis of relapse or refractoriness and CAR T cell infusion, patients require a bridging therapy. To date, this therapy has consisted of highly variable approaches based on local experience. Here, in an European collaborative effort of paediatric and adult haematologists, we summarise current knowledge with the aim of establishing a guidance for bridging therapy. This includes treatment strategies for different patient subgroups, the advantages and disadvantages of low- and highintensity regimens, and the potential impact of bridging therapy on outcome after CAR T cell infusion. This guidance is a step towards a cross-institutional harmonization of bridging therapy, including personalized approaches. This will allow better comparability of clinical data and increase the level of evidence for the treatment of children and young adults with relapsed/refractory B-lineage ALL until CAR T cell infusion.
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Affiliation(s)
- Tobias Feuchtinger
- Department of Paediatric Haematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Germany; Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg.
| | - Peter Bader
- Goethe University, University Hospital, Department for Children and Adolescents, Division for Stern Cell Transplantation, Immunology and Intensive Care, Frankfurt
| | - Marion Subklewe
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Medicine III, University Hospital, LMU Munich, Munich
| | - Maike Breidenbach
- Department of Paediatric Haematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Germany; Bavarian Cancer Research Center (BZKF), R/R ALL Study Group
| | - Semjon Willier
- Department of Paediatric Haematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Germany; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg
| | - Markus Metzler
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen
| | - Nicola Gökbuget
- Department of Medicine II, Haematology/Oncology, Goethe University, Frankfurt
| | - Julia Hauer
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Pediatrics and Children's Cancer Research Centre, TUM School of Medicine, Children's Hospital Munich Schwabing, Technical University of Munich, Munich
| | - Fabian Müller
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich- Alexander University of Erlangen- Nuremberg (FAU), Erlangen
| | - Paul-Gerhardt Schlegel
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; University Children's Hospital Wuerzburg, Wuerzburg
| | - Michael Frühwald
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Pediatrics and Adolescent Medicine, Swabian Children's Cancer Center, University Medical Center Augsburg, Augsburg
| | - Christoph Schmid
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Internal Medicine, University Medical Centre Augsburg, Augsburg
| | - Anja Troeger
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Paediatric Haematology, Oncology and Stem Cell Transplantation, University of Regensburg, Regensburg
| | - Claudia Baldus
- Department of Internal Medicine II, University Hospital Schleswig-Holstein, Kiel
| | - Roland Meisel
- Division of Paediatric Stern Cell Therapy, Department of Paediatric Oncology, Haematology and Clinical Immunology, Medical Faculty, Heinrich-Heine- University, Duesseldorf
| | - Annette Künkele
- Charite-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Paediatric Oncology and Haematology, Berlin
| | - Max Topp
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Medicine II, University Hospital of Wuerzburg, Wuerzburg
| | | | - Gunnar Cario
- Department of Pediatrics, University Medical Center Schleswig-Holstein, Campus Kiel, Germany, Kiel, Schleswig-Holstein
| | - Arend Von Stackelberg
- Charite-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Paediatric Oncology and Haematology, Berlin
| | - Christina Peters
- St. Anna Children's Hospital, St. Anna Children's Research Institute, Medical University Vienna, Vienna
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4
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Peters S, Frisch S, Stock A, Merta J, Bäumer C, Blase C, Schuermann E, Tippelt S, Bison B, Frühwald M, Rutkowski S, Fleischhack G, Timmermann B. Proton Beam Therapy for Pediatric Tumors of the Central Nervous System-Experiences of Clinical Outcome and Feasibility from the KiProReg Study. Cancers (Basel) 2022; 14:cancers14235863. [PMID: 36497345 PMCID: PMC9737072 DOI: 10.3390/cancers14235863] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
As radiotherapy is an important part of the treatment in a variety of pediatric tumors of the central nervous system (CNS), proton beam therapy (PBT) plays an evolving role due to its potential benefits attributable to the unique dose distribution, with the possibility to deliver high doses to the target volume while sparing surrounding tissue. Children receiving PBT for an intracranial tumor between August 2013 and October 2017 were enrolled in the prospective registry study KiProReg. Patient's clinical data including treatment, outcome, and follow-up were analyzed using descriptive statistics, Kaplan-Meier, and Cox regression analysis. Adverse events were scored according to the Common Terminology Criteria for Adverse Events (CTCAE) 4.0 before, during, and after PBT. Written reports of follow-up imaging were screened for newly emerged evidence of imaging changes, according to a list of predefined keywords for the first 14 months after PBT. Two hundred and ninety-four patients were enrolled in this study. The 3-year overall survival of the whole cohort was 82.7%, 3-year progression-free survival was 67.3%, and 3-year local control was 79.5%. Seventeen patients developed grade 3 adverse events of the CNS during long-term follow-up (new adverse event n = 7; deterioration n = 10). Two patients developed vision loss (CTCAE 4°). This analysis demonstrates good general outcomes after PBT.
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Affiliation(s)
- Sarah Peters
- West German Proton Therapy Center Essen (WPE), University Hospital Essen, 45147 Essen, Germany
- Clinic for Particle Therapy, University Hospital Essen, 45147 Essen, Germany
- Correspondence: ; Tel.: +49-201-723-8943
| | - Sabine Frisch
- West German Proton Therapy Center Essen (WPE), University Hospital Essen, 45147 Essen, Germany
| | - Annika Stock
- Department of Neuroradiology, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Julien Merta
- West German Proton Therapy Center Essen (WPE), University Hospital Essen, 45147 Essen, Germany
| | - Christian Bäumer
- West German Proton Therapy Center Essen (WPE), University Hospital Essen, 45147 Essen, Germany
| | - Christoph Blase
- AnästhesieNetz Rhein-Ruhr, Westenfelder Str. 62/64, 44867 Bochum, Germany
| | - Eicke Schuermann
- Department of Pediatric Hematology and Oncology, Pediatrics III, University Hospital Essen, 45147 Essen, Germany
| | - Stephan Tippelt
- Department of Pediatric Hematology and Oncology, Pediatrics III, University Hospital Essen, 45147 Essen, Germany
| | - Brigitte Bison
- Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany
- Neuroradiological Reference Center for the Pediatric Brain Tumor (HIT) Studies of the German Society of Pediatric Oncology and Hematology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Michael Frühwald
- Pediatric and Adolescent Medicine, Swabian Childrens Cancer Center, University Medical Center Augsburg, 86156 Augsburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Gudrun Fleischhack
- Department of Pediatric Hematology and Oncology, Pediatrics III, University Hospital Essen, 45147 Essen, Germany
| | - Beate Timmermann
- West German Proton Therapy Center Essen (WPE), University Hospital Essen, 45147 Essen, Germany
- Clinic for Particle Therapy, University Hospital Essen, 45147 Essen, Germany
- West German Cancer Center (WTZ), 45147 Essen, Germany
- German Cancer Consortium (DKTK), 45147 Essen, Germany
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5
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Penkert J, Strüwe FJ, Dutzmann CM, Doergeloh BB, Montellier E, Freycon C, Keymling M, Schlemmer HP, Sänger B, Hoffmann B, Gerasimov T, Blattmann C, Fetscher S, Frühwald M, Hettmer S, Kordes U, Ridola V, Kroiss Benninger S, Mastronuzzi A, Schott S, Nees J, Prokop A, Redlich A, Seidel MG, Zimmermann S, Pajtler KW, Pfister SM, Hainaut P, Kratz CP. Genotype-phenotype associations within the Li-Fraumeni spectrum: a report from the German Registry. J Hematol Oncol 2022; 15:107. [PMID: 35974385 PMCID: PMC9382737 DOI: 10.1186/s13045-022-01332-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Li-Fraumeni syndrome (LFS) is a cancer predisposition syndrome caused by pathogenic TP53 variants. The condition represents one of the most relevant genetic causes of cancer in children and adults due to its frequency and high cancer risk. The term Li-Fraumeni spectrum reflects the evolving phenotypic variability of the condition. Within this spectrum, patients who meet specific LFS criteria are diagnosed with LFS, while patients who do not meet these criteria are diagnosed with attenuated LFS. To explore genotype-phenotype correlations we analyzed 141 individuals from 94 families with pathogenic TP53 variants registered in the German Cancer Predisposition Syndrome Registry. Twenty-one (22%) families had attenuated LFS and 73 (78%) families met the criteria of LFS. NULL variants occurred in 32 (44%) families with LFS and in two (9.5%) families with attenuated LFS (P value < 0.01). Kato partially functional variants were present in 10 out of 53 (19%) families without childhood cancer except adrenocortical carcinoma (ACC) versus 0 out of 41 families with childhood cancer other than ACC alone (P value < 0.01). Our study suggests genotype-phenotype correlations encouraging further analyses.
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Affiliation(s)
- Judith Penkert
- Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany.,Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Farina J Strüwe
- Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Christina M Dutzmann
- Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Beate B Doergeloh
- Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Emilie Montellier
- Univ. Grenoble Alpes, Inserm 1209, CNRS 5309, Institute for Advanced Biosciences, F38000, Grenoble, France
| | - Claire Freycon
- Univ. Grenoble Alpes, Inserm 1209, CNRS 5309, Institute for Advanced Biosciences, F38000, Grenoble, France.,Department of Pediatrics, Grenoble Alpes University Hospital, Grenoble, France
| | - Myriam Keymling
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Birte Sänger
- Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Beatrice Hoffmann
- Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Tanja Gerasimov
- Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Claudia Blattmann
- Department of Pediatric Oncology, Hematology and Immunology, Olgahospital, Klinikum Stuttgart, Stuttgart, Germany
| | | | - Michael Frühwald
- Paediatric and Adolescent Medicine, University Medical Center Augsburg, Augsburg, Germany
| | - Simone Hettmer
- Division of Pediatric Hematology and Oncology, Department of Pediatric and Adolescent Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Uwe Kordes
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vita Ridola
- Department of Pediatric Oncology and Hematology, MITERA Children's Hospital, Athens, Greece
| | | | - Angela Mastronuzzi
- Department of Haematology, Oncology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Sarah Schott
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Juliane Nees
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Aram Prokop
- Department of Pediatric Hematology/Oncology, Helios Clinic Schwerin, Schwerin, Germany.,Medical School Hamburg (MSH), University of Applied Sciences and Medical University, Hamburg, Germany.,Department of Pediatric Hematology and Oncology, Children's Hospital, Cologne, Germany
| | - Antje Redlich
- Pediatric Oncology Department, Otto von Guericke University Children's Hospital, Magdeburg, Germany
| | - Markus G Seidel
- Division of Pediatric Hematology-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | | | - Kristian W Pajtler
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.,Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan M Pfister
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.,Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Pierre Hainaut
- Univ. Grenoble Alpes, Inserm 1209, CNRS 5309, Institute for Advanced Biosciences, F38000, Grenoble, France
| | - Christian P Kratz
- Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany.
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6
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Dogan M, Hirschfeld G, Blankenburg M, Frühwald M, Ahnert R, Braun S, Marschall U, Zernikow B, Wager J. A randomized controlled trial on long-term effectiveness of a psychosocial aftercare program following pediatric chronic pain treatment: Who benefits the most? Eur J Pain 2022; 26:1746-1758. [PMID: 35762280 DOI: 10.1002/ejp.1998] [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] [Received: 02/15/2022] [Revised: 06/07/2022] [Accepted: 06/26/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND For pediatric chronic pain patients, intensive interdisciplinary pain treatment (IIPT) is a well-established treatment. The treatment's short-term effectiveness can be improved by an additive psychosocial aftercare (PAC). However, neither the program's long-term effectiveness nor the patients in particular need have been investigated yet. METHODS This study aimed at determining the long-term effects of PAC and detecting predictors of treatment outcome within a multicenter randomized controlled trial measured at five time points up to twelve months after discharge. At inpatient admission to IIPT, patients (N=419, 14.3 years of age, 72.3% female) were randomly assigned to intervention or control group. After IIPT discharge, the intervention group received PAC, whereas the control group received treatment as usual (TAU). Patient-reported outcomes included pain and emotional characteristics. Clinicians assessed potential psychosocial risk factors and their prognosis of treatment outcome. Statistical analyses included mixed-models and univariable logistic regressions. RESULTS Data at the 12-month follow-up (n=288) showed a significant benefit of PAC compared with TAU; the majority (59.0%) of patients in the PAC-group reported no chronic pain compared to 29.2% of TAU-patients (p<.001). Patients with a single parent specifically benefited from PAC compared to TAU. Clinicians were able to make a reliable prognosis of treatment outcome, but did not successfully predict which patients would benefit the most from PAC. CONCLUSIONS Study results suggest that PAC is highly effective irrespective of patient characteristics, but particularly for patients with single parents. Its broad implementation could help to improve the long-term outcomes of youth with severely disabling chronic pain.
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Affiliation(s)
- Meltem Dogan
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Gerrit Hirschfeld
- Faculty of Business and Health, University of Applied Sciences Bielefeld, Bielefeld, Germany
| | - Markus Blankenburg
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany.,Paediatric Pain Center Baden-Württemberg, Department of Pediatric Neurology, Olgahospital Stuttgart, Stuttgart, Germany
| | - Michael Frühwald
- University Children's Hospital Augsburg, Swabian Children's Pain Center, Augsburg, Germany
| | - Rosemarie Ahnert
- University Children's Hospital Augsburg, Swabian Children's Pain Center, Augsburg, Germany
| | - Sarah Braun
- Paediatric Pain Center Baden-Württemberg, Department of Pediatric Neurology, Olgahospital Stuttgart, Stuttgart, Germany
| | - Ursula Marschall
- Department of Medicine and Health Services Research, BARMER Health Insurance, Wuppertal, Germany
| | - Boris Zernikow
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Julia Wager
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
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7
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Tschirner S, Adolph JE, Gaab C, Tippelt S, Mikasch R, Mynarek M, Rutkowski S, Pietsch T, Bison B, Warmuth-Metz M, Pfister SM, Milde T, Pajtler KW, Witt O, Frühwald M, Kramm C, Schlegel PG, Kortmann RD, Dietzsch S, Timmermann B, Fleischhack G. MEDB-38. Significance of CSF cytology and neurologic deterioration in relapsed medulloblastomas in the German HIT-REZ-97/-2005 Studies and the HIT-REZ-Register. Neuro Oncol 2022. [PMCID: PMC9165151 DOI: 10.1093/neuonc/noac079.412] [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
BACKGROUND: Follow-up examinations are an essential part of the aftercare of patients with brain tumours. We investigated survival in relation to neurological impairment and positive CSF findings at first relapse/progression of medulloblastomas. METHODS: We collected data from patients with relapsed medulloblastoma from the German HIT-REZ studies (HIT-REZ-1997, HIT-REZ-2005, HIT-REZ-Register, n=342). Survival differences dependent on tumour cell-positive and -negative CSF cytology as well as on new onset or worsening of neurological impairment (i.e. headache, nausea/vomiting, ataxia, seizures and others) were analysed. RESULTS: 247 patients with a recurrent medulloblastoma were evaluable for CSF cytology at first relapse/progression (positive n=97, negative n=150). Patients with tumour cell-positive CSF results showed a significantly shorter median PFS and OS time compared to patients with negative CSF cytology [PFS: 9.1 (CI: 5.3-12.9) vs. 16.8 (CI: 13.8-19.8) months, plog rank test=0.001; OS: 14.4 (CI: 12.3-16.4) vs. 41.8 (CI: 33.3–50.4) months, plog rank test<0.001]. The shortest PFS and OS were observed in SHH-activated (n=18) and group 3 medulloblastomas (n=23) independently of CSF cytology result [median PFSSHH: 4.3 (CI:1.1-12.2), OSSHH: 6.3 (CI:1.1-18.7); PFSgroup3: 4.2 (CI:2.3-13.1), OSgroup3: 13.2 (CI:7.1-18.5) months]. For analysis of the impact of neurological deterioration on survival at first relapse, 249 Patients were evaluable. 105 patients with new or severely worsened neurological impairment at first relapse/progression displayed a significantly poorer PFS and OS time in comparison to 144 patients with unchanged or improved neurological symptoms [PFS: 8.2 (CI: 6.0-10.3) vs. 14.9 (CI: 12.0-17.9) months, plog rank test=0.001; OS: 15.1 (CI: 9.5-20.6) vs. 32.6 (CI: 26.2-38.4) months, plog rank test<0.001]. CONCLUSIONS: Patients with relapsed medulloblastoma show significantly worse survival (PFS and OS) in presence of positive CSF cytology or neurologic deterioration at relapse. These findings could be relevant for patient/parents counselling and treatment recommendations at relapse. Funded by the German Children Cancer Foundation
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Affiliation(s)
- Sebastian Tschirner
- Department of Pediatrics III, Center for Translational Neuro and Behavioral Sciences (CTNBS), University Hospital of Essen , Essen , Germany
| | - Jonas E Adolph
- Department of Pediatrics III, Center for Translational Neuro and Behavioral Sciences (CTNBS), University Hospital of Essen , Essen , Germany
| | - Christine Gaab
- Department of Pediatrics III, Center for Translational Neuro and Behavioral Sciences (CTNBS), University Hospital of Essen , Essen , Germany
| | - Stephan Tippelt
- Department of Pediatrics III, Center for Translational Neuro and Behavioral Sciences (CTNBS), University Hospital of Essen , Essen , Germany
| | - Ruth Mikasch
- Department of Pediatrics III, Center for Translational Neuro and Behavioral Sciences (CTNBS), University Hospital of Essen , Essen , Germany
| | - Martin Mynarek
- University Medical Center Hamburg-Eppendorf, Dept. of Pediatric Hematology and Oncology , Hamburg , Germany
- Mildred Scheel Cancer Career Center HaTriCS, University Medical Center Hamburg Eppendorf , Hamburg , Germany
| | - Stefan Rutkowski
- University Medical Center Hamburg-Eppendorf, Dept. of Pediatric Hematology and Oncology , Hamburg , Germany
| | - Thorsten Pietsch
- Institute of Neuropathology, DGNN Brain Tumor Reference Center, University Hospital of Bonn , Hamburg , Germany
| | - Brigitte Bison
- Department of Neuroradiology, University Hospital Augsburg , Augsburg , Germany
| | - Monika Warmuth-Metz
- Institute of Diagnostic and Interventional Neuroradiology, University Hospital Würzburg , Würzburg , Germany
| | - Stefan M Pfister
- Hopp Children’s Cancer Center Heidelberg (KiTZ); Department of Pediatric Oncology and Hematology, University Hospital Heidelberg, Heidelberg, Germany University Hospital Heidelberg , Heidelberg , Germany
- Division of Pediatric Neurooncology German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Till Milde
- Hopp Children’s Cancer Center Heidelberg (KiTZ); Department of Pediatric Oncology and Hematology, University Hospital Heidelberg, Heidelberg, Germany University Hospital Heidelberg , Heidelberg , Germany
- CCU Pediatric Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) , Heidelberg , Germany
| | - Kristian W Pajtler
- Hopp Children’s Cancer Center Heidelberg (KiTZ); Department of Pediatric Oncology and Hematology, University Hospital Heidelberg, Heidelberg, Germany University Hospital Heidelberg , Heidelberg , Germany
- Division of Pediatric Neurooncology German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Olaf Witt
- Hopp Children’s Cancer Center Heidelberg (KiTZ); Department of Pediatric Oncology and Hematology, University Hospital Heidelberg, Heidelberg, Germany University Hospital Heidelberg , Heidelberg , Germany
- Division of Pediatric Neurooncology German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Michael Frühwald
- University Medical Center Augsburg, Pediatric and Adolescent Medicine, Swabian Children’s Cancer Center , Augsburg , Germany
| | - Christof Kramm
- Division of Pediatric Hematology and Oncology, University Medical Center Göttingen , Göttingen , Germany
| | - Paul-Gerhardt Schlegel
- Department of Pediatric Hematology and Oncology, University Children's Hospital Würzburg , Würzburg , Germany
| | | | - Stefan Dietzsch
- Department of Radio-Oncology, University Leipzig , Leipzig , Germany
| | - Beate Timmermann
- Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen , Essen , Germany
| | - Gudrun Fleischhack
- Department of Pediatrics III, Center for Translational Neuro and Behavioral Sciences (CTNBS), University Hospital of Essen , Essen , Germany
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8
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Blanco-Carmona E, Büllesbach A, Federico A, Liu I, Young MD, Kildisuite G, Behjati S, Vibhakar R, Donson A, Foreman N, Hovestadt V, Shaw M, Chi S, Frühwald M, Drost J, Korshunov A, Hasselblatt M, Pfister SM, Jäger N, Johann P, Filbin M, Kool M. ATRT-10. Single-cell transcriptional profiling of ATRTs reveals heterogeneous signatures of tumor and non-malignant cell populations. Neuro Oncol 2022. [PMCID: PMC9164679 DOI: 10.1093/neuonc/noac079.009] [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
Atypical Teratoid/Rhabdoid Tumors (ATRTs) are known for exhibiting high inter-tumor heterogeneity, even though they are almost all characterized by a common loss of SMARCB1 (or rarely SMARCA4). Three subgroups have been identified at bulk methylome and transcriptome level: ATRT-TYR, ATRT-SHH, and ATRT-MYC. To better understand the biology underlying each subgroup and potentially unveil their (different) cell(s) of origin, we performed single-cell transcriptomic analyses in 22 ATRTs using fresh frozen samples and both 10X and Smartseq technology. All data, grouped by technology, underwent quality control and normalization, regressing out the biases introduced by each sample. Tumor microenvironment (TME) and tumor bulk (TB) clusters were characterized by a combination of copy number variant analyses, enrichment in literature lists of marker genes for specific cell populations, and in-depth analysis of differentially enriched (DE) genes. Non-negative Matrix Factorization (NMF) was applied to TB to reveal major transcriptional profiles, which were grouped into meta-signatures. A total of 71 gene lists were retrieved from NMF (TB) and DE analyses (TME + TB), that gathered into 11 signature groups by Jaccard similarity, with one extra group accounting for unique signatures. Three groups targeted TME, accounting for either microglia, fibroblasts and endothelial cells, or OPCs, oligodendrocytes, astrocytes and neurons. These signatures are enriched in specific clusters across technologies. The remaining eight groups divide into two types, either enriched in clusters predominantly formed by cells of one or two ATRT subgroups or signatures enriched for a particular phenotype, such as cilial, cycling, axonogenesis or EM transition. While the first type is enriched across clusters in a gradient fashion, the second shows enrichment for selected clusters across technologies. Further analyses on the integrated dataset and additional samples are ongoing to validate and refine these 11 signature groups in ATRTs to see how this may lead to new treatment approaches.
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Affiliation(s)
- Enrique Blanco-Carmona
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) , Heidelberg , Germany
| | - Annette Büllesbach
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) , Heidelberg , Germany
| | - Aniello Federico
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) , Heidelberg , Germany
| | - Ilon Liu
- Broad Institute of Harvard and MIT , Cambridge , USA
| | | | | | - Sam Behjati
- Wellcome Sanger Institute , Hinxton , United Kingdom
- Department of Paediatrics , Cambridge , United Kingdom
| | - Rajeev Vibhakar
- Morgan Adams Foundation Pediatric Brain Tumor Research Program , Aurora , USA
- Children’s Hospital Colorado , Aurora , USA
| | - Andrew Donson
- Morgan Adams Foundation Pediatric Brain Tumor Research Program , Aurora , USA
- Children’s Hospital Colorado , Aurora , USA
| | - Nicholas Foreman
- Morgan Adams Foundation Pediatric Brain Tumor Research Program , Aurora , USA
- Children’s Hospital Colorado , Aurora , USA
| | - Volker Hovestadt
- Broad Institute of Harvard and MIT , Cambridge , USA
- Department of Pediatric Oncology, Dana-Farber Boston Children’s Cancer and Blood Disorders Center , Boston , USA
| | - McKenzie Shaw
- Broad Institute of Harvard and MIT , Cambridge , USA
| | - Susan Chi
- Broad Institute of Harvard and MIT , Cambridge , USA
| | - Michael Frühwald
- Swabian Children’s Cancer Center, University Hospital of Augsburg , Augsburg , Germany
| | - Jarno Drost
- Princess Máxima Center for Pediatric Oncology , Utrecht , Netherlands
- Oncode Institute , Utrecht , Netherlands
| | - Andrey Korshunov
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital , Heidelberg , Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK) , Heidelberg , Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster , Münster , Germany
| | - Stefan M Pfister
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) , Heidelberg , Germany
| | - Natalie Jäger
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) , Heidelberg , Germany
| | - Pascal Johann
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Swabian Children’s Cancer Center, University Hospital of Augsburg , Augsburg , Germany
| | - Mariella Filbin
- Broad Institute of Harvard and MIT , Cambridge , USA
- Department of Pediatric Oncology, Dana-Farber Boston Children’s Cancer and Blood Disorders Center , Boston , USA
| | - Marcel Kool
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Princess Máxima Center for Pediatric Oncology , Utrecht , Netherlands
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9
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Sparber-Sauer M, Vokuhl C, Seitz G, Sorg B, Tobias M, von Kalle T, Münter M, Bielack SS, Ladenstein R, Ljungman G, Niggli F, Frühwald M, Loff S, Klingebiel T, Koscielniak E. Infantile myofibromatosis: Excellent prognosis but also rare fatal progressive disease. Treatment results of five Cooperative Weichteilsarkom Studiengruppe (CWS) trials and one registry. Pediatr Blood Cancer 2022; 69:e29403. [PMID: 34636137 DOI: 10.1002/pbc.29403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Infantile myofibromatosis (IM) is a rare benign soft tissue tumor and often a self-limiting disease but rarely includes life-threatening complications. Little is known about optimal treatment of primary localized (LD) and multifocal disease (MFD). METHODS Treatment and outcome of 95 children with IM registered within five Cooperative Weichteilsarkom Studiengruppe (CWS) trials and one registry (1981-2016) were evaluated. RESULTS LD was diagnosed in 71 patients at a median age of 0.4 years (range 0.0-17.7). MFD was present in 24 patients. The mainstay of treatment was watch-and-wait strategy (w&w) after initial biopsy or resection. Low-dose chemotherapy (CHT) was administered to 16/71 (23%) patients with LD and eight of 24 (33%) patients with MFD, imatinib was added in two. A delayed resection was possible in eight of 71 (11%) and five of 24 (21%) patients with LD and MFD, respectively. Overall, patients were alive in complete remission (n = 77) and partial remission (n = 10) at a median follow-up time of 3.4 years after diagnosis (range 0.01-19.4); no data available (n = 5). Three patients died of progressive disease (PD) despite CHT. Gender, tumor size, and location correlated with a favorable event-free survival (EFS) in patients with LD. The 5-year EFS and overall survival of patients with LD were 73% (±12, confidence interval [CI] 95%) and 95% (±6, CI 95%), respectively; for MFD 51% (±22, CI 95%) and 95% (±10, CI 95%). CONCLUSION Prognosis is excellent in patients with LD and MFD. Targeted treatment needs to be evaluated for rare fatal PD.
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Affiliation(s)
- Monika Sparber-Sauer
- Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Stuttgart, Germany.,University of Medicine Tübingen, Tuebingen, Germany
| | - Christian Vokuhl
- Department of Pathology, Section of Pediatric Pathology, Bonn, Germany
| | - Guido Seitz
- Department of Pediatric Surgery, University Children´s Hospital Marburg, Marburg, Germany
| | - Benjamin Sorg
- Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Stuttgart, Germany
| | - Möllers Tobias
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Thekla von Kalle
- Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital, Institute of Radiology, Stuttgart, Germany
| | - Marc Münter
- Klinikum Stuttgart, Institute of Radiotherapy, Stuttgart, Germany
| | - Stefan S Bielack
- Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Stuttgart, Germany.,Department of Pediatric Hematology and Oncology, University of Muenster, Muenster, Germany
| | | | - Gustaf Ljungman
- Department of Women`s and Children`s Health, University of Uppsala, Children`s University Hospital, Uppsala, Sweden
| | - Felix Niggli
- Department of Pediatric Oncology, University of Zurich, Zurich, Switzerland
| | - Michael Frühwald
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Stefan Loff
- Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital, Institute of Pediatric Surgery, Stuttgart, Germany
| | - Thomas Klingebiel
- Department for Children and Adolescents, Universityhospital Frankfurt, Frankfurt, Germany
| | - Ewa Koscielniak
- Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Stuttgart, Germany.,University of Medicine Tübingen, Tuebingen, Germany
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10
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Maier F, Frühwald M, Heinrich U, Schimmel M, Wahl D, Eggermann T. Overgrowth-associated partial trisomy 15q24.3-qter and mosaic 11p15.5 duplication involving Silver-Russell region in a patient with lateralized asymmetry and developmental delay. Clin Dysmorphol 2021; 30:189-193. [PMID: 34117161 DOI: 10.1097/mcd.0000000000000378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Felicitas Maier
- Department of Clinical Genetics, MVZ Martinsried, Munich
- Ambulance for Clinical Genetics, Praxis Dr. Wahl, Praxis für Humangenetik
| | - Michael Frühwald
- Department of Neuropediatrics, I. Klinik für Kinder und Jugendliche, Universitätsklinikum Augsburg, Augsburg
| | - Uwe Heinrich
- Department of Clinical Genetics, MVZ Martinsried, Munich
| | - Mareike Schimmel
- Department of Neuropediatrics, I. Klinik für Kinder und Jugendliche, Universitätsklinikum Augsburg, Augsburg
| | - Dagmar Wahl
- Department of Clinical Genetics, MVZ Martinsried, Munich
- Ambulance for Clinical Genetics, Praxis Dr. Wahl, Praxis für Humangenetik
| | - Thomas Eggermann
- Department for Imprinting Disorders, Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
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11
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Kordes U, Mautner VF, Oyen F, Hagel C, Hartmann C, Heuser M, Frühwald M, Hasselblatt M, Oehl-Huber K, Siebert R, Schneppenheim R, Schüller U. Evidence for a low-penetrant extended phenotype of rhabdoid tumor predisposition syndrome type 1 from a kindred with gain of SMARCB1 exon 6. Pediatr Blood Cancer 2021; 68:e29185. [PMID: 34101994 DOI: 10.1002/pbc.29185] [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: 02/13/2021] [Revised: 05/27/2021] [Accepted: 05/30/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Uwe Kordes
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Victor-Felix Mautner
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Oyen
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Hagel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Hartmann
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Michael Heuser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Michael Frühwald
- University Children's Hospital Augsburg, Swabian Children's Cancer Center, Augsburg, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Kathrin Oehl-Huber
- Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany
| | - Reiner Siebert
- Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany
| | - Reinhard Schneppenheim
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrich Schüller
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany
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12
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Dogan M, Hirschfeld G, Blankenburg M, Frühwald M, Ahnert R, Braun S, Marschall U, Pfenning I, Zernikow B, Wager J. Effectiveness of a Psychosocial Aftercare Program for Youth Aged 8 to 17 Years With Severe Chronic Pain: A Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2127024. [PMID: 34570203 PMCID: PMC8477265 DOI: 10.1001/jamanetworkopen.2021.27024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Severe chronic pediatric pain causes individual suffering and significantly affects social functioning and psychological well-being. For children with high pain severity, intensive interdisciplinary pain treatment (IIPT) is a well-established treatment. However, across specialized centers, it is not sufficient for all patients. OBJECTIVE To evaluate the effectiveness of a psychosocial aftercare (PAC) program for pediatric patients with severe chronic pain followed up for 6 months after discharge from IIPT. DESIGN, SETTING, AND PARTICIPANTS This multicenter randomized clinical trial with 4 assessment points (pre-IIPT, immediately post-IIPT, 3 months, and 6 months) was conducted at 3 pediatric specialized tertiary care pain centers in Germany between September 11, 2018, and March 31, 2020. Included patients were aged 8 to 17 with a severe chronic pain condition who had been admitted for IIPT. Data were analyzed from June 8 to September 4, 2020. INTERVENTIONS Patients and their families were randomly assigned to 1 of 2 study groups at inpatient IIPT admission. Both groups received standardized 3- to 4-week IIPT. After IIPT discharge, the intervention group received PAC and the control group received usual care. PAC involved ongoing contact with a social worker for as long as the family requested the support, up to a maximum of 6 months. MAIN OUTCOMES AND MEASURES The primary outcome measure was pain at 6 months, measured using the Chronic Pain Grading (CPG), an instrument based on an algorithm indicating severity of the chronic pain disorder. Secondary outcomes included other pain-related and emotional parameters. RESULTS A total of 419 patients were randomized (mean [SD] age, 14.3 [2.1] years; 303 [72.3%] girls; 116 [27.7%] boys), with 218 assigned to usual care and 201 assigned to PAC. At baseline in both groups, the median (IQR) CPG was 3 (2-4). Superiority of PAC compared with usual care was demonstrated at 6 months (median [IQR] CPG: usual care, 2 [2-3]; PAC, 1 [1-2]; r = 0.30; 95% CI, 0.17-0.41). Additionally, PAC significantly improved emotional parameters (eg, significant time × group interaction: b = -8.84; P < .001). CONCLUSIONS AND RELEVANCE This randomized clinical trial found that PAC improved pain-related and emotional parameters during the intervention 6 months after discharge from IIPT. Future research is needed to investigate the intervention's long-term effects. TRIAL REGISTRATION German Clinical Trials Register ID: DRKS00015230.
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Affiliation(s)
- Meltem Dogan
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital, Datteln, Germany
- Department of Children’s Pain Therapy and Paediatric Palliative Care, Faculty of Health, Witten/Herdecke University School of Medicine, Witten, Germany
| | - Gerrit Hirschfeld
- Faculty of Business and Health, University of Applied Sciences Bielefeld, Bielefeld, Germany
| | - Markus Blankenburg
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital, Datteln, Germany
- Paediatric Pain Center Baden-Württemberg, Department of Pediatric Neurology, Olgahospital Stuttgart, Stuttgart, Germany
| | - Michael Frühwald
- University Children’s Hospital Augsburg, Swabian Children’s Pain Center, Augsburg, Germany
| | - Rosemarie Ahnert
- University Children’s Hospital Augsburg, Swabian Children’s Pain Center, Augsburg, Germany
| | - Sarah Braun
- Paediatric Pain Center Baden-Württemberg, Department of Pediatric Neurology, Olgahospital Stuttgart, Stuttgart, Germany
| | - Ursula Marschall
- Department of Medicine and Health Services Research, BARMER Health Insurance, Wuppertal, Germany
| | - Ingo Pfenning
- Techniker Krankenkasse, Techniker Health Insurance, Hamburg, Germany
| | - Boris Zernikow
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital, Datteln, Germany
- Department of Children’s Pain Therapy and Paediatric Palliative Care, Faculty of Health, Witten/Herdecke University School of Medicine, Witten, Germany
| | - Julia Wager
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital, Datteln, Germany
- Department of Children’s Pain Therapy and Paediatric Palliative Care, Faculty of Health, Witten/Herdecke University School of Medicine, Witten, Germany
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13
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Berthold F, Rosswog C, Christiansen H, Frühwald M, Hemstedt N, Klingebiel T, Fröhlich B, Schilling FH, Schmid I, Simon T, Hero B, Fischer M, Ernst A. Clinical and molecular characterization of patients with stage 4(M) neuroblastoma aged less than 18 months without MYCN amplification. Pediatr Blood Cancer 2021; 68:e29038. [PMID: 33826231 DOI: 10.1002/pbc.29038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/23/2021] [Accepted: 03/13/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The survival of children with stage 4(M) neuroblastoma without MYCN amplification and below the age of 18 months is considered better than the still dismal outcome of older high-risk neuroblastoma patients. This study analyzes the impact of clinical and molecular characteristics on the long-term outcome. PATIENTS AND METHODS Clinical presentation, survival, and recurrence patterns of patients enrolled onto trials NB90, NB97, and NB2004 were retrospectively analyzed. Gene expression signatures based on RNA microarrays (TH10) were investigated if tumor material was available. RESULTS Between 1990 and 2015, 177 patients with stage 4(M) MYCN nonamplified neuroblastoma aged less than 18 months at diagnosis were eligible. After a median follow-up of 9.7 years (IQR 5.0, 13.4), the proportions of 10-year event-free survival (EFS) and overall survival (OS) were 73% (95% confidence interval [CI] 67-79%) and 86% (95% CI 80-92%), respectively. Of the 27 neuroblastoma recurrences, 44% occurred in more than one site. Four additional patients presented histologically mature ganglioneuroma at recurrence. Six patients developed a secondary malignancy. The secondary 5-year EFS and OS of the 27 patients with neuroblastoma recurrence were 44% and 59%, respectively. TH10 gene expression signature was not prognostically predictive in the investigated subcohort. CONCLUSION The outcome of patients with stage 4(M) neuroblastoma aged less than 18 months is favorable when treated with high-risk or otherwise intensive therapy. The development of secondary malignancies and the potential of maturation to ganglioneuroma call for a controlled stepwise reduction of treatment intensity.
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Affiliation(s)
- Frank Berthold
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
| | - Carolina Rosswog
- Department of Experimental Pediatric Oncology, University of Cologne, Cologne, Germany.,Center for Molecular Medicine, Medical Faculty, University of Cologne, Cologne, Germany
| | - Holger Christiansen
- Department of Pediatric Oncology and Hematology, University of Leipzig, Leipzig, Germany
| | - Michael Frühwald
- Swabian Children's Cancer Center, Children's Hospital, University Hospital Augsburg, Augsburg, Germany
| | - Nadine Hemstedt
- Department of Experimental Pediatric Oncology, University of Cologne, Cologne, Germany.,Center for Molecular Medicine, Medical Faculty, University of Cologne, Cologne, Germany
| | - Thomas Klingebiel
- Department of Children and Adolescents, University Hospital, Goethe University Frankfurt (Main), Frankfurt, Germany
| | - Birgit Fröhlich
- Department of Pediatric Oncology and Hematology, University of Munster, Munster, Germany
| | - Freimut H Schilling
- Department of Pediatric Oncology and Hematology, Olgahospital Stuttgart, Stuttgart, Germany
| | - Irene Schmid
- Department of Pediatric Hematology and Oncology and Hematology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Thorsten Simon
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
| | - Barbara Hero
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
| | - Matthias Fischer
- Department of Experimental Pediatric Oncology, University of Cologne, Cologne, Germany.,Center for Molecular Medicine, Medical Faculty, University of Cologne, Cologne, Germany
| | - Angela Ernst
- Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
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14
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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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15
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Mehaffey C, Wahl D, Schaller T, Blattner-Johnson M, Claus R, Frühwald M, Kuhlen M. Heterozygous PALB2 Mutation in a Boy with Acute Lymphoblastic Leukemia and Subsequent Metastatic Ewing Sarcoma. Klin Padiatr 2021; 233:141-144. [PMID: 33772500 DOI: 10.1055/a-1404-3243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Carla Mehaffey
- Pediatric and Adolescent Medicine, University Medical Center Augsburg, Augsburg, Germany
| | - Dagmar Wahl
- Medical Practice for Genetic Counselling, Center for Human Genetics and Laboratory Diagnostics Martinsried, Augsburg, Germany
| | - Tina Schaller
- Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg, Germany
| | - Mirjam Blattner-Johnson
- Hopp Children's Cancer Center Heidelberg (KiTZ), German Cancer Research Center (DKFZ) and Heidelberg University Hospital, Heidelberg, Germany
| | - Rainer Claus
- Department of Internal Medicine, University Medical Center Augsburg, Augsburg, Germany
| | - Michael Frühwald
- Pediatric and Adolescent Medicine, University Medical Center Augsburg, Augsburg, Germany
| | - Michaela Kuhlen
- Pediatric and Adolescent Medicine, University Medical Center Augsburg, Augsburg, Germany
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16
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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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17
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Melchior P, Dzierma Y, Rübe C, Graf N, Kager L, Dieckmann K, Kroiss S, Hubertus J, Warmann S, Schenk JP, Leuschner I, Nemes K, Meier CM, Vokuhl C, Frühwald M, Furtwängler R. Local Stage Dependent Necessity of Radiation Therapy in Rhabdoid Tumors of the Kidney (RTK). Int J Radiat Oncol Biol Phys 2020; 108:667-675. [PMID: 32407933 DOI: 10.1016/j.ijrobp.2020.04.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/15/2020] [Accepted: 04/30/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Rhabdoid tumor of the kidney (RTK) is one of the most aggressive childhood renal tumors. Overall survival ranges from 22% to 47%. The indication for radiation therapy (RT) in usually very young patients is an ongoing discussion. Recent protocols recommend RT independent of local stage, the latter being a good discriminator in other childhood kidney tumors. In this study, we analyze the evidence for RT in regard to risk factors, including tumor stage. METHODS AND MATERIALS This study analyzed 58 patients with RTK from Austria, Switzerland, and Germany treated in the framework of 4 consecutive, prospective renal/rhabdoid tumor studies from 1991 to 2014. All treatment protocols included multimodality treatment, including high-intensity chemotherapy, surgery, and RT. RESULTS Local stage distribution was not applicable, I, II, and III in 1, 6, 11, and 40, respectively. Twenty-nine (50%) patients had stage IV disease at diagnosis. Thirty-seven patients (64%) achieved complete remission, and 49% (18/37) relapsed. Thirty-four patients (60%) patients had progressive disease and died, 17 had local disease, 10 had combined disease, and 7 had distant disease; 2 treatment-related deaths were reported (3%). Twenty-one patients received RT during first-line treatment, 18 of them to all involved sites. Eight of the 34 cases of progressive disease occurred in irradiated patients. The local failure rate of treated patients with local stage II or III disease was 29% (6/18) in patients irradiated to all sites compared with 68% (15/22) in nonirradiated patients. One of 6 stage I patients received RT, and 1 patient experienced distant relapse (2-year progression-free and overall survival both 83% ± 15%). Progression-free survival for local stage II and III disease treated with RT, adjusted for early relapse or treatment abandonment, was 67% ± 11%, compared with 15% ± 7% without RT (P < .0001). CONCLUSION The 68% local failure rate in nonirradiated patients underlines the importance of local treatment. Our experience supports the use of RT for local control in higher stage disease. In contrast, no local relapse in 6 local stage I patients, including 5 nonirradiated patients, suggests omission of RT in this favorable subset of usually infant patients with RTK.
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Affiliation(s)
- Patrick Melchior
- Department of Radiation Oncology, Saarland University Hospital, Homburg, Germany.
| | - Yvonne Dzierma
- Department of Radiation Oncology, Saarland University Hospital, Homburg, Germany
| | - Christian Rübe
- Department of Radiation Oncology, Saarland University Hospital, Homburg, Germany
| | - Norbert Graf
- Department of Pediatric Hematology and Oncology, Saarland University Hospital, Homburg/Saar, Germany
| | - Leo Kager
- St. Anna Children's Hospital, Department of Pediatrics, Medical University Vienna, Vienna, Austria
| | - Karin Dieckmann
- Department of Radiation Oncology, Medical University Vienna, Vienna, Austria
| | - Sabine Kroiss
- Department of Pediatric Hematology and Oncology, Children's Hospital, Zurich University, Zurich, Switzerland
| | - Jochen Hubertus
- Department of Pediatric Surgery, von Haunersches Kinderspital, Ludwigs-Maximilians University, Munich, Germany
| | - Steven Warmann
- Department of Pediatric Surgery, Tübingen University Hospital, Tübingen, Germany
| | - Jens-Peter Schenk
- Department of Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Ivo Leuschner
- Department of Paidopathology, Schleswig-Holstein-University Hospital, Campus Kiel, Kiel, Germany; Section of Pediatric Pathology, Department of Pathology, University Hospital Bonn, Bonn, Germany
| | - Karolina Nemes
- Swabian Children's Cancer Center, University Children's Hospital Augsburg, Augsburg, Germany
| | | | - Christian Vokuhl
- Department of Paidopathology, Schleswig-Holstein-University Hospital, Campus Kiel, Kiel, Germany; Deceased
| | - Michael Frühwald
- Swabian Children's Cancer Center, University Children's Hospital Augsburg, Augsburg, Germany
| | - Rhoikos Furtwängler
- Department of Pediatric Hematology and Oncology, Saarland University Hospital, Homburg/Saar, Germany
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18
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Kunz JB, Lobitz S, Grosse R, Oevermann L, Hakimeh D, Jarisch A, Cario H, Beier R, Schenk D, Schneider D, Groß-Wieltsch U, Prokop A, Heine S, Khurana C, Erlacher M, Dürken M, Linke C, Frühwald M, Corbacioglu S, Claviez A, Metzler M, Ebinger M, Full H, Wiesel T, Eberl W, Reinhard H, Tagliaferri L, Allard P, Karapanagiotou-Schenkel I, Rother LM, Beck D, Le Cornet L, Kulozik AE. Sickle cell disease in Germany: Results from a national registry. Pediatr Blood Cancer 2020; 67:e28130. [PMID: 31867835 DOI: 10.1002/pbc.28130] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Limited data on the prevalence and medical care of sickle cell disease (SCD) in Germany are available. Here, we make use of a patient registry to characterize the burden of disease and the treatment modalities for patients with SCD in Germany. PROCEDURE A nationwide German registry for patients with SCD documents basic data on diagnosis and patient history retrospectively at the time of registration. A prospective annual documentation provides more details on complications and treatment of SCD. For the current analyses, data of 439 patients were available. RESULTS Most patients had homozygous SCD (HbSS 75.1%, HbS/β-thalassemia 13.2%, and HbSC 11.3%). The median age at diagnosis was 1.9 years (interquartile range, 0.6-4.4 years), most patients were diagnosed when characteristic symptoms occurred. Sepsis and stroke had affected 3.2% and 4.2% of patients, respectively. During the first year of observation, 48.3% of patients were admitted to a hospital and 10.1% required intensive care. Prophylactic penicillin was prescribed to 95.6% of patients with homozygous SCD or HbS/β thalassemia below the age of six and hydroxycarbamide to 90.4% of patients above the age of two years. At least one annual transcranial Doppler ultrasound was documented for 74.8% of patients between 2 and 18 years. CONCLUSION With an estimated number of at least 2000, the prevalence of SCD in Germany remains low. Prospectively, we expect that the quality of care for children with SCD will be further improved by an earlier diagnosis after the anticipated introduction of a newborn screening program for SCD.
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Affiliation(s)
- Joachim B Kunz
- Department of Pediatric Oncology, Hematology and Immunology, Hopp-Children's Cancer Center (KiTZ) Heidelberg, University of Heidelberg, Heidelberg, Germany.,GPOH Konsortium Sichelzellkrankheit, Germany
| | - Stephan Lobitz
- GPOH Konsortium Sichelzellkrankheit, Germany.,Gemeinschaftsklinikum Mittelrhein, Kemperhof, Pädiatrische Hämatologie und Onkologie, Koblenz, Germany
| | - Regine Grosse
- GPOH Konsortium Sichelzellkrankheit, Germany.,Universitätsklinikum Hamburg-Eppendorf, Zentrum für Geburtshilfe, Kinder- und Jugendmedizin, Klinik und Poliklinik für Pädiatrische Hämatologie und Onkologie, Hamburg, Germany
| | - Lena Oevermann
- GPOH Konsortium Sichelzellkrankheit, Germany.,Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Klinik für Pädiatrie m.S. Onkologie/Hämatologie/KMT, Berlin, Germany
| | - Dani Hakimeh
- GPOH Konsortium Sichelzellkrankheit, Germany.,Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Klinik für Pädiatrie m.S. Onkologie/Hämatologie/KMT, Berlin, Germany
| | - Andrea Jarisch
- GPOH Konsortium Sichelzellkrankheit, Germany.,Klinikum der Johann-Wolfgang-Goethe-Universität, Zentrum für Kinder- und Jugendmedizin, Schwerpunkt Stammzelltransplantation und Immunologie, Frankfurt am Main, Germany
| | - Holger Cario
- GPOH Konsortium Sichelzellkrankheit, Germany.,Universitätsklinikum Ulm, Klinik für Kinder- und Jugendmedizin, Pädiatrische Hämatologie und Onkologie, Ulm, Germany
| | - Rita Beier
- University Hospital Essen, Pediatric Haematology and Oncology, Essen, Germany
| | - Daniela Schenk
- Department of Pediatrics and Children's Cancer Research Center, Kinderklinik München Schwabing, Klinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, Munich, Germany
| | - Dominik Schneider
- Clinic of Pediatrics, Dortmund Municipal Hospital, Dortmund, Germany
| | - Ute Groß-Wieltsch
- Pediatrics 5 (Oncology, Hematology, Immunology), Center for Pediatric, Adolescent and Women's Medicine, Klinikum Stuttgart - Olgahospital, Stuttgart, Germany
| | - Aram Prokop
- Children's Hospital Amsterdamer Straße Cologne, Clinic for Children and Youth Medicine, Paediatric Oncology/Haematology, Cologne, Germany
| | - Sabine Heine
- Department of Pediatric Hematology and Oncology, Saarland University Hospital, Homburg, Saar, Germany
| | - Claudia Khurana
- Klinik für Kinder- und Jugendmedizin, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Miriam Erlacher
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Breisgau, Germany
| | - Matthias Dürken
- Department of Pediatric Hematology and Oncology, University of Mannheim, Mannheim, Germany
| | - Christina Linke
- Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin - Pädiatrische Hämatologie und Onkologie, Münster, Germany
| | - Michael Frühwald
- University Children's Hospital Augsburg, University Hospital Augsburg, Augsburg, Germany
| | - Selim Corbacioglu
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Franz-Josef-Strauss-Allee 11, University Hospital of Regensburg, Regensburg, Germany
| | - Alexander Claviez
- Klinik für Kinder- und Jugendmedizin I, Pädiatrische Onkologie, Hämatologie, Stammzelltransplantation, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Markus Metzler
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Martin Ebinger
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | | | - Thomas Wiesel
- Children's Hospital, Vestische Youth Hospital, University of Witten/Herdecke, Datteln, Germany
| | - Wolfgang Eberl
- Institute for Clinical Transfusion Medicine and Children's Hospital, Klinikum Braunschweig GmbH, Germany
| | - Harald Reinhard
- Asklepios Kinderklinik Sankt Augustin, St. Augustin, Germany
| | - Laura Tagliaferri
- Department of Pediatric Oncology, Hematology and Immunology, Hopp-Children's Cancer Center (KiTZ) Heidelberg, University of Heidelberg, Heidelberg, Germany.,GPOH Konsortium Sichelzellkrankheit, Germany
| | - Pierre Allard
- Department of Pediatric Oncology, Hematology and Immunology, Hopp-Children's Cancer Center (KiTZ) Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Irini Karapanagiotou-Schenkel
- NCT Trial Center, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Lisa-Marie Rother
- NCT Trial Center, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Dorothea Beck
- NCT Trial Center, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Lucian Le Cornet
- NCT Trial Center, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Andreas E Kulozik
- Department of Pediatric Oncology, Hematology and Immunology, Hopp-Children's Cancer Center (KiTZ) Heidelberg, University of Heidelberg, Heidelberg, Germany.,GPOH Konsortium Sichelzellkrankheit, Germany
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19
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Berthold F, Faldum A, Ernst A, Boos J, Dilloo D, Eggert A, Fischer M, Frühwald M, Henze G, Klingebiel T, Kratz C, Kremens B, Krug B, Leuschner I, Schmidt M, Schmidt R, Schumacher-Kuckelkorn R, von Schweinitz D, Schilling FH, Theissen J, Volland R, Hero B, Simon T. Extended induction chemotherapy does not improve the outcome for high-risk neuroblastoma patients: results of the randomized open-label GPOH trial NB2004-HR. Ann Oncol 2020; 31:422-429. [PMID: 32067684 DOI: 10.1016/j.annonc.2019.11.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 10/04/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Long-term survival of high-risk neuroblastoma patients is still below 50% despite intensive multimodal treatment. This trial aimed to address whether the addition of two topotecan-containing chemotherapy courses compared to standard induction therapy improves event-free survival (EFS) of these patients. PATIENTS AND METHODS An open-label, multicenter, prospective randomized controlled trial was carried out at 58 hospitals in Germany and Switzerland. Patients aged 1-21 years with stage 4 neuroblastoma and patients aged 6 months to 21 years with MYCN-amplified tumors were eligible. The primary endpoint was EFS. Patients were randomly assigned to standard induction therapy with six chemotherapy courses or to experimental induction chemotherapy starting with two additional courses of topotecan, cyclophosphamide, and etoposide followed by standard induction chemotherapy (eight courses in total). After induction chemotherapy, all patients received high-dose chemotherapy with autologous hematopoietic stem cell rescue and isotretinoin for consolidation. Radiotherapy was applied to patients with active tumors at the end of induction chemotherapy. RESULTS Of 536 patients enrolled in the trial, 422 were randomly assigned to the control arm (n = 211) and the experimental arm (n = 211); the median follow-up time was 3.32 years (interquartile range 1.65-5.92). At data lock, the 3-year EFS of experimental and control patients was 34% and 32% [95% confidence Interval (CI) 28% to 40% and 26% to 38%; P = 0.258], respectively. Similarly, the 3-year overall survival of the patients did not differ [54% and 48% (95% CI 46% to 62% and 40% to 56%), respectively; P = 0.558]. The response to induction chemotherapy was not different between the arms. The median number of non-fatal toxicities per patient was higher in the experimental group while the median number of toxicities per chemotherapy course was not different. CONCLUSION While the burden for the patients was increased by prolonging the induction chemotherapy and the toxicity, the addition of two topotecan-containing chemotherapy courses did not improve the EFS of high-risk neuroblastoma patients and thus cannot be recommended. CLINICAL TRIALS. GOV NUMBER NCT number 03042429.
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Affiliation(s)
- F Berthold
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany.
| | - A Faldum
- Institute of Medical Statistics and Clinical Research, University of Muenster, Muenster, Germany
| | - A Ernst
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Cologne, Germany
| | - J Boos
- Department of Pediatric Oncology and Hematology, University of Muenster, Muenster, Germany
| | - D Dilloo
- Department of Pediatric Oncology and Hematology, University of Bonn, Bonn, Germany
| | - A Eggert
- Department of Pediatric Oncology and Hematology, Charité Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany
| | - M Fischer
- Department of Experimental Pediatric Oncology and Center for Molecular Medicine, Medical Faculty, University of Cologne, Cologne, Germany
| | - M Frühwald
- Swabian Children's Cancer Center, Children's Hospital, University Hospital Augsburg, Augsburg, Germany
| | - G Henze
- Department of Pediatric Oncology and Hematology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - T Klingebiel
- Department of Children and Adolescents, University Hospital, Goethe University Frankfurt (Main), Frankfurt am Main, Germany
| | - C Kratz
- Department of Pediatric Oncology and Hematology, Medicinal University, Hannover, Germany
| | - B Kremens
- Department of Pediatric Oncology and Hematology, University of Essen, Essen, Germany
| | - B Krug
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - I Leuschner
- Children's Tumor Registry, Institute of Pathology, University of Kiel, Kiel, Germany
| | - M Schmidt
- Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - R Schmidt
- Institute of Medical Statistics and Clinical Research, University of Muenster, Muenster, Germany
| | | | - D von Schweinitz
- Department of Pediatric Surgery, University of Munich, Munich, Germany
| | - F H Schilling
- Department of Pediatric Oncology and Hematology, Olgahospital Stuttgart, Stuttgart, Germany
| | - J Theissen
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
| | - R Volland
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
| | - B Hero
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
| | - T Simon
- Department of Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
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20
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Holsten T, Alawi M, Spohn M, Hasselblatt M, Haberler C, Antonelli M, Koch A, Kool M, Frühwald M, Schüller U. ATRT-21. COMPARATIVE INTEGRATIVE ANALYSIS OF PRIMARY AND RELAPSED ATYPICAL TERATOID/RHABDOID TUMORS (AT/RTs). Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.019] [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)
- Till Holsten
- Research Institute, Children’s Cancer Center Hamburg, Hamburg, Germany
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Malik Alawi
- Heinrich-Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
- Bioinformatics Core, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Spohn
- Heinrich-Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | | | - Manila Antonelli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, University of Rome, Rome, Italy
| | - Arend Koch
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Berlin Institute of Health, department of Neuropathology, Berlin, Germany
| | - Marcel Kool
- Hopp Children’s Cancer Center at the NCT amd German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - Michael Frühwald
- Children’s Hospital Augsburg, Swabian Children’s Cancer Center, Augsburg, Germany
| | - Ulrich Schüller
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Research Institute, Children’s Cancer Center Hamburg, Hamburg, Germany
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21
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Galarza NM, Holdhof D, Interlandi M, Melcher V, Graf M, Kastrati D, Meisterernst M, Johann P, Kool M, Frühwald M, Schüller U, Kerl K. ATRT-07. MURINE SOX2-POSITIVE EARLY PRECURSOR CELLS GIVE RISE TO RHABDOID TUMORS WITH FEATURES OF THE HUMAN ATRT-MYC GROUP. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.006] [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)
- Natalia Moreno Galarza
- Department of Pediatric Hematology and Oncology, University Children’s Hospital, Westfalian-Wilhelms-University, Muenster, Germany
| | - Dörthe Holdhof
- Research Institute Children’s Cancer Center Hamburg, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Marta Interlandi
- Department of Pediatric Hematology and Oncology, University Children’s Hospital, Westfalian-Wilhelms-University, Muenster, Germany
| | - Viktoria Melcher
- Department of Pediatric Hematology and Oncology, University Children’s Hospital, Westfalian-Wilhelms-University, Muenster, Germany
| | - Monika Graf
- Department of Pediatric Hematology and Oncology, University Children’s Hospital, Westfalian-Wilhelms-University, Muenster, Germany
| | - Dennis Kastrati
- Department of Pediatric Hematology and Oncology, University Children’s Hospital, Westfalian-Wilhelms-University, Muenster, Germany
| | - Michael Meisterernst
- Institute of Molecular Tumor Biology Muenster, University Hospital Muenster, Muenster, Germany
| | - Pascal Johann
- Hopp Children’s Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
| | - Marcel Kool
- Hopp Children’s Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Frühwald
- Children’s Hospital Augsburg, Swabian Children’s Cancer Center, Augsburg, Germany
| | - Ulrich Schüller
- Research Institute Children’s Cancer Center Hamburg, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Kornelius Kerl
- Department of Pediatric Hematology and Oncology, University Children’s Hospital, Westfalian-Wilhelms-University, Muenster, Germany
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22
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Marcu A, Trautwein N, Stevanovic S, Johann P, Technau A, Lager J, Monoranu CM, Henkel L, Krauß J, Ebinger M, Schuhmann M, Thomale U, Pietsch T, Wölfl M, Schlegel PG, Frühwald M, Oyen F, Reisner Y, Rammensee HG, Eyrich M. IMMU-28. DECIPHERING THE AT/RT LIGANDOME. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.344] [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)
- Ana Marcu
- Department of Immunology, University of Tübingen, Tübingen, Germany
| | - Nico Trautwein
- Department of Immunology, University of Tübingen, Tübingen, Germany
| | | | | | - Antje Technau
- Children’s Hospital, University Medical Center, Würzburg, Germany
| | - Johanna Lager
- Children’s Hospital, University Medical Center, Würzburg, Germany
| | | | - Lisa Henkel
- Children’s Hospital, University Medical Center, Würzburg, Germany
| | - Jürgen Krauß
- Department of Neurosurgery, University Medical Center, Würzburg, Germany
| | - Martin Ebinger
- Children’s Hospital, University Medical Center, Tübingen, Germany
| | - Martin Schuhmann
- Department of Neurosurgery, University Medical Center, Tübingen, Germany
| | | | - Torsten Pietsch
- Institute of Neuropathology, DGNN Brain Tumor Reference Center, Bonn, Germany
| | - Matthias Wölfl
- Children’s Hospital, University Medical Center, Würzburg, Germany
| | | | | | - Florian Oyen
- Children’s Hospital, University Medical Center, Hamburg, Germany
| | | | | | - Matthias Eyrich
- Children’s Hospital, University Medical Center, Würzburg, Germany
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23
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Dietlein M, Biermann M, Frühwald M, Linden T, Bucsky P, Reiners C, Schober O, Franzius C. Procedure guideline for radioiodine therapy and 131iodine whole-body scintigraphy in paediatric patients with differentiated thyroid cancer. Nuklearmedizin 2017; 46:224-31. [DOI: 10.1160/nukmed-0288] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryThe procedure guideline for radioiodine (131I) therapy and 131I whole-body scintigraphy of differentiated thyroid cancer in paediatric patients is the counterpart to the procedure guidelines (version 3) for adult patients and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Characteristics of thyroid cancer in children are the higher aggressiveness of papillary thyroid cancer, the higher frequency of extrathyroidal extension and of disseminated pulmonary metastases as well as the high risk of local recurrences. Radioiodine therapy is generally recommended in children, the 131I activity depends on the children's body weight. Radioiodine ablation in children with small papillary cancer (≤1 cm) should be considered. TSH stimulation is reached two weeks (children) or three weeks (adolescents) after withdrawal of thyroid hormones. Anti-emetic drugs are highly recommended. CT of the chest and examination of pulmonary function are clearly indicated if there is any suspicion on metastases. 3–6 months after 131I ablation, the 131I whole-body scintigraphy is highly recommended as lymph node metastases are frequently detected in paediatric patients. Follow-up care should be arranged in shorter intervals than in adults to test the compliance and to adapt dosage of thyroid hormones to the children's body weight. Reference values of fT3 are higher in children than in adults. Evidence is insufficient to describe in which constellation the TSH may be kept within the low normal level. Therefore, TSH suppression is generally recommended.
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Holsten T, Hasselblatt M, Kordes U, Siebert R, Schneppenheim R, Frühwald M, Schüller U. GENE-02. GERMLINE MUTATIONS WITHIN THE SWI/SNF COMPLEX PREDICT PATIENTS’ AGE OF ONSET AND TYPE OF DISEASE. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox083.073] [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: 11/13/2022] Open
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25
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van den Bruck R, Weil PP, Ziegenhals T, Schreiner P, Juranek S, Gödde D, Vogel S, Schuster F, Orth V, Dörner J, Pembaur D, Röper M, Störkel S, Zirngibl H, Wirth S, Jenke ACW, Postberg J, Boy N, Heringer J, Haege G, Glahn EM, Hoffmann GF, Garbade SF, Burgard P, Kölker S, Chao CM, Yahya F, Moiseenko A, Shrestha A, Ahmadvand N, Quantius J, Wilhelm J, El-Agha E, Zimmer KP, Bellusci S, Staufner C, Kölker S, Prokisch H, Hoffmann GF, Seeliger S, Müller M, Hippe A, Steinkraus H, Wauer R, Lachmann B, Hofmann SR, Hedrich CM, Zierk J, Arzideh F, Haeckel R, Rascher W, Rauh M, Metzler M, Thieme S, Bandoła J, Richter C, Ryser M, Jamal A, Ashton MP, von Bonin M, Kuhn M, Hedrich CM, Bonifacio E, Berner R, Brenner S, Hammersen J, Has C, Naumann-Bartsch N, Stachel D, Kiritsi D, Söder S, Tardieu M, Metzler M, Bruckner-Tuderman L, Schneider H, Bohne F, Langer D, Cencic R, Eggermann T, Zechner U, Pelletier J, Zepp F, Enklaar T, Prawitt D, Pech M, Weckmann M, Heinsen FA, Franke A, Happle C, Dittrich AM, Hansen G, Fuchs O, von Mutius E, Oliver BG, Kopp MV, Paret C, Russo A, Theruvath J, Keller B, El Malki K, Lehmann N, Wingerter A, Neu MA, Aslihan GA, Wagner W, Sommer C, Pietsch T, Seidmann L, Faber J, Schreiner F, Ackermann M, Michalik M, Rother E, Bilkei-Gorzo A, Racz I, Bindila L, Lutz B, Dötsch J, Zimmer A, Woelfle J, Fischer HS, Ullrich TL, Bührer C, Czernik C, Schmalisch G, Stein R, Hofmann SR, Hagenbuchner J, Kiechl-Kohlendorfer U, Obexer P, Ausserlechner MJ, Loges NT, Frommer AT, Wallmeier J, Omran H, Öner-Sieben S, Gimpfl M, Rozman J, Irmler M, Beckers J, De Angelis MH, Roscher A, Wolf E, Ensenauer R, Nemes K, Frühwald M, Hasselblatt M, Siebert R, Kordes U, Kool M, Wang H, Hardy H, Refai O, Barwick KES, Zimmerman HH, Weis J, Baple EL, Crosby AH, Cirak S, Hellmuth C, Uhl O, Standl M, Heinrich J, Thiering E, Koletzko B, Blümel L, Kerl K, Picard D, Frühwald MC, Liebau MC, Reifenberger G, Borkhardt A, Hasselblatt M, Remke M, Tews D, Wabitsch M, Fischer-Posovszky P, Westhoff MA, Nonnenmacher L, Langhans J, Schneele L, Trenkler N, Debatin KM. Abstracts of the 52nd Workshop for Pediatric Research : Frankfurt, Germany. 27-28 October 2016. Mol Cell Pediatr 2017; 4:5. [PMID: 28516419 PMCID: PMC5435609 DOI: 10.1186/s40348-017-0071-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Rhea van den Bruck
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Patrick P Weil
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Thomas Ziegenhals
- Chair of Biochemistry, Theodor-Boveri-Institute at the Biocenter, University of Würzburg, Würzburg, Germany
| | - Philipp Schreiner
- Chair of Biochemistry, Theodor-Boveri-Institute at the Biocenter, University of Würzburg, Würzburg, Germany
| | - Stefan Juranek
- Chair of Biochemistry, Theodor-Boveri-Institute at the Biocenter, University of Würzburg, Würzburg, Germany
| | - Daniel Gödde
- Molecular Pathology Department, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Silvia Vogel
- Molecular Pathology Department, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Frauke Schuster
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Valerie Orth
- Department of Surgery II, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Johannes Dörner
- Department of Surgery II, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Daniel Pembaur
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Meike Röper
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Stefan Störkel
- Molecular Pathology Department, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Hubert Zirngibl
- Department of Surgery II, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Stefan Wirth
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Andreas C W Jenke
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Jan Postberg
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Nikolas Boy
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Jana Heringer
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Gisela Haege
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Esther M Glahn
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Georg F Hoffmann
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Sven F Garbade
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Peter Burgard
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Stefan Kölker
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Cho-Ming Chao
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,Department for General Pediatrics and Neonatology, University Children's Hospital, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Faady Yahya
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Alena Moiseenko
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Amit Shrestha
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Negah Ahmadvand
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Jennifer Quantius
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Jochen Wilhelm
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Elie El-Agha
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Klaus-Peter Zimmer
- Department for General Pediatrics and Neonatology, University Children's Hospital, Gießen, Germany
| | - Saverio Bellusci
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Christian Staufner
- Department of General Pediatrics, University Children's Hospital, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Stefan Kölker
- Department of General Pediatrics, University Children's Hospital, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Holger Prokisch
- Institute of Human Genetics, Helmholtz Zentrum München, 85764, Neuherberg, Germany.,Institute of Human Genetics, Technische Universität München, 81675, Munich, Germany
| | - Georg F Hoffmann
- Department of General Pediatrics, University Children's Hospital, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Stephan Seeliger
- Department of Pediatric Cardiology, Intensive Care and Neonatology, University Hospital Goettingen, 37075, Goettingen, Germany.,Clinics for children and adolescents, 86633, Neuburg/Donau, Germany
| | - Matthias Müller
- Department of Pediatric Cardiology, Intensive Care and Neonatology, University Hospital Goettingen, 37075, Goettingen, Germany
| | - Andreas Hippe
- Department of Dermatology, Heinrich Heine University, 40225, Duesseldorf, Germany
| | - Henrik Steinkraus
- Department of Anesthesiology, MSP, Surgical Intensive Care Medicine, University Hospital, Charité, Campus Virchow Clinic, 13353, Berlin, Germany
| | - Roland Wauer
- Department of Neonatology, Charité, University of Medicine, 10098, Berlin, Germany
| | - Burkhard Lachmann
- Department of Anesthesiology, MSP, Surgical Intensive Care Medicine, University Hospital, Charité, Campus Virchow Clinic, 13353, Berlin, Germany
| | - Sigrun R Hofmann
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Christian M Hedrich
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Jakob Zierk
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Farhad Arzideh
- Department of Statistics, University of Bremen, Bremen, Germany
| | - Rainer Haeckel
- Bremer Zentrum für Laboratoriumsmedizin, Klinikum Bremen Mitte, Bremen, Germany
| | - Wolfgang Rascher
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Manfred Rauh
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Markus Metzler
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Sebastian Thieme
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Joanna Bandoła
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Cornelia Richter
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Martin Ryser
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Arshad Jamal
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Michelle P Ashton
- DFG-Center for Regenerative Therapies Dresden, Cluster of Excellence, Technische Universitaet Dresden, Dresden, Germany
| | - Malte von Bonin
- Medical Clinic I, University Clinic Dresden, Dresden, Germany.,DKTK-German Cancer Consortium, Partner Site Dresden, University Clinic Dresden, Dresden, Germany.,DKFZ-German Cancer Research Center, Heidelberg, Germany
| | - Matthias Kuhn
- Institute for Medical Informatics and Biometry, Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | | | - Ezio Bonifacio
- DFG-Center for Regenerative Therapies Dresden, Cluster of Excellence, Technische Universitaet Dresden, Dresden, Germany
| | - Reinhard Berner
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Sebastian Brenner
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany.,DFG-Center for Regenerative Therapies Dresden, Cluster of Excellence, Technische Universitaet Dresden, Dresden, Germany
| | - Johanna Hammersen
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | - Cristina Has
- Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Daniel Stachel
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | - Dimitra Kiritsi
- Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Stephan Söder
- Department of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - Mathilde Tardieu
- Dermatologie Pédiatrique, University Hospital Grenoble, Grenoble, France
| | - Markus Metzler
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | | | - Holm Schneider
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | - F Bohne
- Centre for Paediatrics and Adolescent Medicine, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - D Langer
- Centre for Paediatrics and Adolescent Medicine, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - R Cencic
- Department of Biochemistry and The Rosalind and Morris Goodman Cancer Research; Centre, McGill University, Montreal, Quebec, H3G 1Y6, Canada
| | - T Eggermann
- Institute of Human Genetics, RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - U Zechner
- Institute of Human Genetics, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - J Pelletier
- Department of Biochemistry and The Rosalind and Morris Goodman Cancer Research; Centre, McGill University, Montreal, Quebec, H3G 1Y6, Canada
| | - F Zepp
- Centre for Paediatrics and Adolescent Medicine, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - T Enklaar
- Centre for Paediatrics and Adolescent Medicine, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - D Prawitt
- Centre for Paediatrics and Adolescent Medicine, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - Martin Pech
- University Medical Center Schleswig-Holstein, Division Pediatric Pneumology & Allergology, Campus Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), Member of of the German Center of Lung Research (DZL), Borstel, Germany
| | - Markus Weckmann
- University Medical Center Schleswig-Holstein, Division Pediatric Pneumology & Allergology, Campus Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), Member of of the German Center of Lung Research (DZL), Borstel, Germany
| | - Femke-Anouska Heinsen
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Christine Happle
- Hannover Medical School, Department of Pediatric Pneumology, Allergology and Neonatology, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of of the German Center of Lung Research (DZL), Hannover, Germany
| | - Anna-Maria Dittrich
- Hannover Medical School, Department of Pediatric Pneumology, Allergology and Neonatology, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of of the German Center of Lung Research (DZL), Hannover, Germany
| | - Gesine Hansen
- Hannover Medical School, Department of Pediatric Pneumology, Allergology and Neonatology, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of of the German Center of Lung Research (DZL), Hannover, Germany
| | - Oliver Fuchs
- Ludwig-Maximilians-University Munich, Dr von Hauner Children's Hospital, Munich, Germany.,Comprehensive Pneumology Center München (CPC-M), Member of of the German Center of Lung Research (DZL), Munich, Germany
| | - Erika von Mutius
- Ludwig-Maximilians-University Munich, Dr von Hauner Children's Hospital, Munich, Germany.,Comprehensive Pneumology Center München (CPC-M), Member of of the German Center of Lung Research (DZL), Munich, Germany
| | - Brian G Oliver
- Woolcock Institute of Medical Research, Sydney, Australia
| | - Matthias V Kopp
- University Medical Center Schleswig-Holstein, Division Pediatric Pneumology & Allergology, Campus Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), Member of of the German Center of Lung Research (DZL), Borstel, Germany
| | - Claudia Paret
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexandra Russo
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Johanna Theruvath
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bettina Keller
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Khalifa El Malki
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Nadine Lehmann
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Arthur Wingerter
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marie A Neu
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Gerhold-Ay Aslihan
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Wolfgang Wagner
- Section of Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Clemens Sommer
- Devision of Neuropathology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Torsten Pietsch
- Department of Neuropathology, University of Bonn, Bonn, Germany
| | - Larissa Seidmann
- Institute of Pathology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jörg Faber
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,UCT Mainz, Mainz, Germany
| | - Felix Schreiner
- Pediatric Endocrinology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Merle Ackermann
- Pediatric Endocrinology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Michael Michalik
- Pediatric Endocrinology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Eva Rother
- Pediatric Endocrinology, Children's Hospital, University of Cologne, Cologne, Germany
| | | | - Ildiko Racz
- Molecular Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Laura Bindila
- Institute for Physiological Chemistry, University Medical Center, Mainz, Germany
| | - Beat Lutz
- Institute for Physiological Chemistry, University Medical Center, Mainz, Germany
| | - Jörg Dötsch
- Pediatric Endocrinology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Andreas Zimmer
- Molecular Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Joachim Woelfle
- Pediatric Endocrinology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Hendrik S Fischer
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - Tim L Ullrich
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - Christoph Bührer
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - Christoph Czernik
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - Gerd Schmalisch
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - Robert Stein
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Sigrun R Hofmann
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | | | - Petra Obexer
- Department of Pediatrics II, Innsbruck, Austria.,Tyrolean Cancer Research Institute, Innsbruck, Austria
| | | | - Niki T Loges
- Department of General Pediatrics, University Children's Hospital Muenster, Muenster, Germany
| | - Adrien Tobias Frommer
- Department of General Pediatrics, University Children's Hospital Muenster, Muenster, Germany
| | - Julia Wallmeier
- Department of General Pediatrics, University Children's Hospital Muenster, Muenster, Germany
| | - Heymut Omran
- Department of General Pediatrics, University Children's Hospital Muenster, Muenster, Germany
| | - Soner Öner-Sieben
- Experimental Pediatrics, University Children's Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Martina Gimpfl
- Research Center, University Children's Hospital, Ludwig-Maximilians-Universität (LMU) München, München, Germany
| | - Jan Rozman
- Institute of Experimental Genetics, Helmholtz Zentrum München, München, Germany
| | - Martin Irmler
- Institute of Experimental Genetics, Helmholtz Zentrum München, München, Germany
| | - Johannes Beckers
- Institute of Experimental Genetics, Helmholtz Zentrum München, München, Germany
| | | | - Adelbert Roscher
- Research Center, University Children's Hospital, Ludwig-Maximilians-Universität (LMU) München, München, Germany
| | - Eckhard Wolf
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU München, München, Germany
| | - Regina Ensenauer
- Experimental Pediatrics, University Children's Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Research Center, University Children's Hospital, Ludwig-Maximilians-Universität (LMU) München, München, Germany
| | - Karolina Nemes
- Children's Hospital Augsburg, Swabian Children's Cancer Center, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Michael Frühwald
- Children's Hospital Augsburg, Swabian Children's Cancer Center, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Pottkamp 2, 48149, Münster, Germany
| | - Reiner Siebert
- Department of Human Genetics, Institute of Human Genetics, University of Ulm, Ulm, Germany
| | - Uwe Kordes
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Marcel Kool
- Division of Pediatric Neurooncology (B062), German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Haicui Wang
- Uniklinik Köln, Klinik für Kinderheilkunde und Jugendmedizin, Köln, Germany
| | - Holly Hardy
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
| | | | - Katy E S Barwick
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
| | - Holly H Zimmerman
- University of Mississippi, Medical Center of Jackson, Jackson, MS, USA
| | - Joachim Weis
- Uniklinik Aachen, Institut für Neuropathologie, Aachen, Germany
| | - Emma L Baple
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
| | - Andrew H Crosby
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
| | - Sebahattin Cirak
- Uniklinik Köln, Klinik für Kinderheilkunde und Jugendmedizin, Köln, Germany
| | - C Hellmuth
- Ludwig-Maximilian-Universität Munich, Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - O Uhl
- Ludwig-Maximilian-Universität Munich, Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - M Standl
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
| | - J Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - E Thiering
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
| | - B Koletzko
- Ludwig-Maximilian-Universität Munich, Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Lena Blümel
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Division of Pediatric Neuro-Oncogenomics, German Cancer Consortium and German Cancer Research Center - partner site Essen/Düsseldorf, Düsseldorf, Germany.,Institute of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Kornelius Kerl
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
| | - Daniel Picard
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Division of Pediatric Neuro-Oncogenomics, German Cancer Consortium and German Cancer Research Center - partner site Essen/Düsseldorf, Düsseldorf, Germany.,Institute of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Michael C Frühwald
- Swabian Childrens' Cancer Center, Children's Hospital Augsburg, Augsburg, Germany
| | - Max C Liebau
- Department of Pediatrics and Center for Molecular Medicine, University Hospital Cologne, Cologne, Germany
| | - Guido Reifenberger
- Institute of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Arndt Borkhardt
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Marc Remke
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Division of Pediatric Neuro-Oncogenomics, German Cancer Consortium and German Cancer Research Center - partner site Essen/Düsseldorf, Düsseldorf, Germany.,Institute of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - D Tews
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - M Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - P Fischer-Posovszky
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Mike-Andrew Westhoff
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Lisa Nonnenmacher
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Julia Langhans
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Lukas Schneele
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Nancy Trenkler
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Klaus-Michael Debatin
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
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Frühwald M, Kachanov D, Zlatic M, Clement N, Shamaskaya T, Varfolomeeva S, Schneppenheim R, Siebert R, Gerss J, Hasselblatt M, Bourdeaut F. AT-06THE EXTRAORDINARY CHALLENGE OF TREATING PATIENTS WITH CONGENITAL RHABDOID TUMORS - DATA FROM FRANCE, RUSSIA AND THE EU-RHAB REGISTRY. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now065.05] [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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Frühwald M, Nemes K, Schlegel PG, Schmid I, Gerss J, Schneppenheim R, Siebert R, Kerl K, Hernaiz-Driever P, Kool M, Hasselblatt M, Nysom K. AT-13THE EU-RHAB EXPERIENCE: CLINICAL, GENETIC AND SURVIVAL DATA DEFINE A STANDARD OF CARE AND ARE THE BASIS FOR CLINICAL TRIALS. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now065.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Johann PD, Erkek S, Zapatka M, Kerl K, Buchhalter I, Hovestadt V, Korshunov A, Marina R, Jones DT, Northcott PA, Frühwald M, Gajjar A, Hasselblatt M, Pfister SM, Kool M. PTPS-11ATYPICAL TERATOID/RHABDOID TUMOUR IS AN EPIGENETICALLY HETEROGENEOUS DISEASE CHARACTERIZED BY SUBGROUP SPECIFIC SUPER-ENHANCERS. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov228.11] [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: 11/12/2022] Open
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Tallen G, Resch A, Calaminus G, Wiener A, Leiss U, Pletschko T, Friedrich C, Langer T, Grabow D, Driever PH, Kortmann RD, Timmermann B, Pietsch T, Warmuth-Metz M, Bison B, Thomale UW, Krauss J, Mynarek M, von Hoff K, Ottensmeier H, Frühwald M, Kramm CM, Temming P, Müller HL, Witt O, Kordes U, Fleischhack G, Gnekow A, Rutkowski S. Strategies to improve the quality of survival for childhood brain tumour survivors. Eur J Paediatr Neurol 2015; 19:619-39. [PMID: 26278499 DOI: 10.1016/j.ejpn.2015.07.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 07/05/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Tumours of the central nervous system (CNS) are the most frequent solid tumours and the second most frequent type of cancer in children and adolescents. Overall survival has continuously improved in Germany, since an increasing number of patients have been treated according to standardised, multicentre, multimodal treatment recommendations, trials of the German Paediatric Brain Tumour Consortium (HIT-Network) or the International Society of Paediatric Oncology-Europe (SIOP-E) during the last decades. Today, two out of three patients survive. At least 8000 long-term childhood brain tumour survivors (CBTS) are currently living in Germany. They face lifelong disease- and treatment-related late effects (LE) and associated socioeconomic problems more than many other childhood cancer survivors (CCS). METHOD We review the LE and resulting special needs of this particular group of CCS. RESULTS Despite their increasing relevance for future treatment optimisation, neither the diversity of chronic and cumulative LE nor their pertinent risk factors and subsequent impact on quality of survival have yet been comprehensively addressed for CBTS treated according to HIT- or SIOP-E-protocols. Evidence-based information to empower survivors and stakeholders, as well as medical expertise to manage their individual health care, psychosocial and educational/vocational needs must still be generated and established. CONCLUSION The establishment of a long-term research- and care network in Germany shall contribute to a European platform, that aims at optimising CBTSs' transition into adulthood as resilient individuals with high quality of survival including optimal levels of activity, participation and acceptance by society.
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Affiliation(s)
- Gesche Tallen
- Department of Paediatric Oncology/Haematology, Charité-Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany; Department of Paediatrics, Faculty of Medicine, University of Calgary, 2888 Shaganappi Trail N.W., Calgary, Alberta T3B 6A8, Canada.
| | - Anika Resch
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.
| | - Gabriele Calaminus
- Department of Paediatric Haematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.
| | - Andreas Wiener
- Department of Paediatric Haematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.
| | - Ulrike Leiss
- Medical University Vienna, Department of Paediatric and Adolescent Medicine, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Thomas Pletschko
- Medical University Vienna, Department of Paediatric and Adolescent Medicine, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Carsten Friedrich
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany; Division of Paediatric Oncology, Haematology and Haemostaseology, Department of Woman's and Children's Health, University Hospital Leipzig, Liebigstr. 20a, 04103 Leipzig, Germany.
| | - Thorsten Langer
- Department of Paediatric Oncology/Haematology, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
| | - Desiree Grabow
- German Childhood Cancer Registry (GCCR), Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center, University of Mainz, Gebäude 902, Obere Zahlbacher Straße 69, 55131 Mainz, Germany.
| | - Pablo Hernáiz Driever
- Department of Paediatric Oncology/Haematology, Charité-Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Rolf-Dieter Kortmann
- Department of Radiation Oncology, University of Leipzig, Stephanstr. 9a, 04103 Leipzig, Germany.
| | - Beate Timmermann
- Particle Therapy Clinic at West German Proton Therapy Centre Essen, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Torsten Pietsch
- Institute of Neuropathology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.
| | - Monika Warmuth-Metz
- Dept. of Neuroradiology, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany.
| | - Brigitte Bison
- Dept. of Neuroradiology, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany.
| | - Ulrich-Wilhelm Thomale
- Department of Paediatric Neurosurgery, Charité-Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Jürgen Krauss
- Department of Neurosurgery, Head Clinic, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany.
| | - Martin Mynarek
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.
| | - Katja von Hoff
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.
| | - Holger Ottensmeier
- University Children's Hospital Würzburg, Dept. of Paed. Haematology, Oncology, Josef-Schneider-Str. 2, 97080 Würzburg, Germany.
| | - Michael Frühwald
- Department of Paediatric Oncology/Haematology, Klinikum Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Christof M Kramm
- Division of Paediatric Haematology and Oncology, University of Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
| | - Petra Temming
- Paediatric Haematology/Oncology, Paediatrics III, University of Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Hermann L Müller
- Paediatric Oncology/Haematology, Klinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Str. 10, 26133 Oldenburg, Germany.
| | - Olaf Witt
- German Cancer Research Centre (DKFZ) and Department of Paediatric Oncology/Haematology, University of Heidelberg, Heidelberg, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Uwe Kordes
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.
| | - Gudrun Fleischhack
- Paediatric Haematology/Oncology, Paediatrics III, University of Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Astrid Gnekow
- Department of Paediatric Oncology/Haematology, Klinikum Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Stefan Rutkowski
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.
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Kerl K, Moreno N, Kool M, Holsten T, Mertins J, Meisterernst M, Frühwald M. Arsenic Trioxide Inhibits Tumor Cell Growth in Malignant Rhabdoid Tumor Cell In Vitro and In Vivo by Targeting Overexpressed Gli1. Cancer Genet 2014. [DOI: 10.1016/j.cancergen.2014.09.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Johann P, Korshunov A, Kerl K, Huang A, Jabado N, Hasselblatt M, Frühwald M, Pfister S, Kool M. CNS AT/RTs are a Heterogeneous Entity That Comprises Subgroups with Distinct Molecular Profiles. Cancer Genet 2014. [DOI: 10.1016/j.cancergen.2014.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hasselblatt M, Brokinkel B, Bartelheim K, Schneppenheim R, Siebert R, Frühwald M. Prognostic Value of Clinical, Histopathological and Molecular Features in AT/RT. Cancer Genet 2014. [DOI: 10.1016/j.cancergen.2014.09.018] [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: 10/24/2022]
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Mauz-Körholz C, Hasenclever D, Holzendorf V, Jürgens H, Burdach S, Eggert A, Berthold F, Müller H, Frühwald M, Klingebiel T, Metzler M, Körholz D. Feasibility of VECOPA a Dose-Intensive Regimen for Pediatric Intermediate and Advanced Stage Hodgkin's Lymphoma: Results of the GPOH-HD-2002/VECOPA-Pilot Study. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Seeringer A, Bartelheim K, Kerl K, Hasselblatt M, Leuschner I, Rutkowski S, Timmermann B, Kortmann RD, Koscielniak E, Schneppenheim R, Warmuth-Metz M, Gerß J, Siebert R, Graf N, Boos J, Frühwald M. Feasibility of Intensive Multimodal Therapy in Infants Affected by Rhabdoid Tumors – Experience of the EU-RHAB registry. Klin Padiatr 2014; 226:143-8. [DOI: 10.1055/s-0034-1368719] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- A. Seeringer
- Swabian Children’s Cancer Center, Children’s Hospital Augsburg, Germany
| | - K. Bartelheim
- Swabian Children’s Cancer Center, Children’s Hospital Augsburg, Germany
| | - K. Kerl
- Hematology and Oncology, University Children’s Hospital Münster, Germany
| | | | - I. Leuschner
- Institute of Pathology Christian-Albrechts-University Kiel, Germany
| | - S. Rutkowski
- Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B. Timmermann
- Westgerman Protontherapycenter Essen, University Essen, Germany
| | | | - E. Koscielniak
- Pediatric Hematology and Oncology, Olgahospital Stuttgart, Germany
| | - R. Schneppenheim
- Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - J. Gerß
- Institute of Biometry and Clinical Research, University of Münster, Germany
| | - R. Siebert
- Institute of Human Genetics, Christian-Albrechts-University Kiel, Germany
| | - N. Graf
- Pediatric Hematology and Oncology, University Hospital Homburg, Germany
| | - J. Boos
- Hematology and Oncology, University Children’s Hospital Münster, Germany
| | - M. Frühwald
- Swabian Children’s Cancer Center, Children’s Hospital Augsburg, Germany
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Kerl K, Ries D, Unland R, Borchert C, Moreno N, Hasselblatt M, Jürgens H, Kool M, Görlich D, Eveslage M, Jung M, Meisterernst M, Frühwald M. The histone deacetylase inhibitor SAHA acts in synergism with fenretinide and doxorubicin to control growth of rhabdoid tumor cells. BMC Cancer 2013; 13:286. [PMID: 23764045 PMCID: PMC3693872 DOI: 10.1186/1471-2407-13-286] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [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: 05/20/2013] [Accepted: 06/04/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Rhabdoid tumors are highly aggressive malignancies affecting infants and very young children. In many instances these tumors are resistant to conventional type chemotherapy necessitating alternative approaches. METHODS Proliferation assays (MTT), apoptosis (propidium iodide/annexin V) and cell cycle analysis (DAPI), RNA expression microarrays and western blots were used to identify synergism of the HDAC (histone deacetylase) inhibitor SAHA with fenretinide, tamoxifen and doxorubicin in rhabdoidtumor cell lines. RESULTS HDAC1 and HDAC2 are overexpressed in primary rhabdoid tumors and rhabdoid tumor cell lines. Targeting HDACs in rhabdoid tumors induces cell cycle arrest and apoptosis. On the other hand HDAC inhibition induces deregulated gene programs (MYCC-, RB program and the stem cell program) in rhabdoid tumors. These programs are in general associated with cell cycle progression. Targeting these activated pro-proliferative genes by combined approaches of HDAC-inhibitors plus fenretinide, which inhibits cyclinD1, exhibit strong synergistic effects on induction of apoptosis. Furthermore, HDAC inhibition sensitizes rhabdoid tumor cell lines to cell death induced by chemotherapy. CONCLUSION Our data demonstrate that HDAC inhibitor treatment in combination with fenretinide or conventional chemotherapy is a promising tool for the treatment of chemoresistant rhabdoid tumors.
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Affiliation(s)
- Kornelius Kerl
- Department of Pediatric Hematology and Oncology, University Childrens' Hospital Muenster, Muenster, Germany
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Hasselblatt M, Isken S, Linge A, Eikmeier K, Jeibmann A, Oyen F, Nagel I, Richter J, Bartelheim K, Kordes U, Schneppenheim R, Frühwald M, Siebert R, Paulus W. High-resolution genomic analysis suggests the absence of recurrent genomic alterations other than SMARCB1 aberrations in atypical teratoid/rhabdoid tumors. Genes Chromosomes Cancer 2012; 52:185-90. [PMID: 23074045 DOI: 10.1002/gcc.22018] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Accepted: 09/18/2012] [Indexed: 01/09/2023] Open
Abstract
Atypical teratoid/rhabdoid tumor (AT/RT) is a rare malignant pediatric brain tumor characterized by genetic alterations affecting the SMARCB1 (hSNF5/INI1) locus in chromosome band 22q11.2. To identify potential additional genetic alterations, high-resolution genome-wide analysis was performed using a molecular inversion probe single-nucleotide polymorphism (MIP SNP) assay (Affymetrix OncoScan formalin-fixed paraffin-embedded express) on DNA isolated from 18 formalin-fixed paraffin-embedded archival samples. Alterations affecting the SMARCB1 locus could be demonstrated by MIP SNP in 15 out of 16 evaluable cases (94%). These comprised five tumors with homozygous deletions, six tumors with heterozygous deletions, and four tumors with copy number neutral loss of heterozygosity (LOH) involving chromosome band 22q11.2. Remarkably, MIB SNP analysis did not yield any further recurrent chromosomal gains, losses, or copy neutral LOH. On MIP SNP screening for somatic mutations, the presence of a SMARCB1 mutation (c.472C>T p.R158X) was confirmed, but no recurrent mutations of other cancer relevant genes could be identified. Results of fluorescence in situ hybridization, multiplex ligation-dependent probe amplification, and SMARCB1 sequencing were highly congruent with that of the MIP SNP assay. In conclusion, these data further suggest the absence of recurrent genomic alterations other than SMARCB1 in AT/RT.
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Affiliation(s)
- Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany.
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Redlich A, Boxberger N, Schmid KW, Frühwald M, Rohrer T, Vorwerk P. Sensitivity of fine-needle biopsy in detecting pediatric differentiated thyroid carcinoma. Pediatr Blood Cancer 2012; 59:233-7. [PMID: 22184105 DOI: 10.1002/pbc.24051] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [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: 07/12/2011] [Accepted: 11/21/2011] [Indexed: 11/08/2022]
Abstract
BACKGROUND Differentiated thyroid carcinomas (DTC) are uncommon in children. Since the frequency of malignancy is assumed to be high in pediatric symptomatic thyroid nodules, carcinomas should be ruled out reliably. The objective of this study was to assess the sensitivity of fine-needle biopsy (FNB) in diagnosing children with DTC. PROCEDURE We retrospectively analyzed 15 years of data from the GPOH-MET registry, a database by the German Society for Pediatric Oncology and Hematology (GPOH) with a focus on malignant endocrine tumors (MET). We reviewed data on pediatric patients with DTC who had undergone FNB. FNB results were classified according to well-established guidelines. RESULTS During the study period, 206 children with a histological diagnosis of DTC were entered into the GPOH-MET database. Fifty of those patients aged 3.6-17.3 years (mean, 12.3 years) had undergone FNB preoperatively. Forty-one were diagnosed with papillary thyroid carcinoma (PTC), seven with follicular thyroid carcinoma (FTC), and two had DTC not otherwise specified. Of the first FNB performed on each patient, the cytological specimens were diagnosed as benign in 13 cases, malignant in 14, suspicious in 9, follicular neoplasms in 6, and unsatisfactory in 8. The sensitivity of FNB in detecting DTC was 69.0%. CONCLUSIONS Our results reflect the current practice of pediatric thyroid FNB in Germany. In order to improve its usefulness, FNB should always be performed by experienced physicians. Furthermore, a central review of all specimens is necessary to ascertain the validity of the cytological diagnosis and to introduce immunocytological and molecular methods.
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Affiliation(s)
- Antje Redlich
- Department of Pediatric Hematology and Oncology, Otto-von-Guericke-University Magdeburg, GPOH-MET Study Center, Magdeburg, Germany
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Grunewald TGP, Greulich N, Kontny U, Frühwald M, Rutkowski S, Kordes U, Scheurlen W, Schmidt W, Stachel D, Metzler M, Mittler U, Graf N, Benesch M, Burdach S. Targeted therapeutics in treatment of children and young adults with solid tumors: an expert survey and review of the literature. Klin Padiatr 2012; 224:124-31. [PMID: 22522984 DOI: 10.1055/s-0032-1301930] [Citation(s) in RCA: 8] [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] [Indexed: 10/28/2022]
Abstract
Although prognosis of children with solid tumors is steadily improving, long-term survival is not achievable in all patients, especially in patients with recurrent or refractory disease. Despite the increasing number of targeted therapeutics (TT), only very few TT have been introduced into clinical protocols. Accordingly, clinical experience concerning the efficacy and safety of these drugs is limited. This may possibly discourage oncologists from administering TT to children.We performed a comprehensive review of the literature to identify TT that may be considered for treatment of children and young adults with solid tumors. Moreover, we interviewed an expert panel of the Society for Pediatric Oncology and Hematology (GPOH) using questionnaires in a modified Delphi process in order to describe the experts' experiences in the use of these TT.Among 30 TT identified to be possibly useful in children and young adults, imatinib, bevacizumab and rapamycin were most widely used. These drugs were reported as having mostly little to no severe adverse events and seem to induce at least partial responses in a subset of patients. In addition, our study confirms and expands the present knowledge about adverse events and the potential efficacy of 5 other commonly used TT in this population.This information may be useful for oncologists when administering these TT to children and young adults with solid tumors. Controlled clinical trials are urgently needed to test their safety and efficacy.
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Affiliation(s)
- T G P Grunewald
- Department of Pediatrics, Children's Cancer Research and Roman Herzog Comprehensive Cancer Center, Klinikum rechts der Isar, TU München, Munich, Germany.
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Warmann SW, Nourkami N, Frühwald M, Leuschner I, Schenk JP, Fuchs J, Graf N. Primary lung metastases in pediatric malignant non-Wilms renal tumors: data from SIOP 93-01/GPOH and SIOP 2001/GPOH. Klin Padiatr 2012; 224:148-52. [PMID: 22513793 DOI: 10.1055/s-0032-1304600] [Citation(s) in RCA: 8] [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] [Indexed: 10/28/2022]
Abstract
Malignant non-Wilms renal tumors (NWRT) are a small but relevant subgroup of renal neoplasms in children. In this study we analyzed corresponding data from the trials SIOP 93-01/GPOH and SIOP 2001/GPOH of the Society of Pediatric Oncology and Hematology.Data of 22 patients with NWRT and primary lung metastases were retrospectively reviewed. Analyses included epidemiology, tumor characteristics, chemotherapy, local treatment, and outcome.The following diagnoses were registered: Malignant Rhabdoid tumor of the kidney (MRTK, n=15), Renal-cell carcinoma (RCC, n=3), Clear-cell sarcoma of the kidney (CCSK, n=3), and primitive neuro ectodermal tumor (PNET, n=1). Median age of patients at diagnosis was 14 months. Overall survival was 36.36% (8/22). Of the 15 children with MRTK 3 survived, 3/3 patients with RCC, 1/3 patients with CCSK, and 1/1 patient with PNET survived. Lung metastases disappeared in 6 patients after initial chemotherapy, 6/8 patients undergoing local treatment of lung metastases (surgery, irradiation, or both) achieved complete remission. Only patients with complete clearance of lung lesions, either through neoadjuvant chemotherapy or subsequent local treatment, survived. Mean Follow up was 31 months (1-137).Survival of patients with stage IV NWRT is dismal. Complete removal of lung metastases seems mandatory for survival. An aggressive diagnostic and therapeutic approach seems justified in affected children.
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Affiliation(s)
- S W Warmann
- Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Tuebingen, Germany.
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Baum SH, Frühwald M, Rahbar K, Wessling J, Schober O, Weckesser M. Contribution of PET/CT to Prediction of Outcome in Children and Young Adults with Rhabdomyosarcoma. J Nucl Med 2011; 52:1535-40. [DOI: 10.2967/jnumed.110.082511] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [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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Neuner B, von Mackensen S, Krümpel A, Manner D, Friefeld S, Nixdorf S, Frühwald M, deVeber G, Nowak-Göttl U. Health-related quality of life in children and adolescents with stroke, self-reports, and parent/proxies reports: Cross-sectional investigation. Ann Neurol 2011; 70:70-8. [DOI: 10.1002/ana.22381] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 12/17/2010] [Accepted: 01/14/2011] [Indexed: 11/06/2022]
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Antonelli M, Hasselblatt M, Haberler C, Di Giannatale A, Garrè ML, Donofrio V, Lauriola L, Ridola V, Arcella A, Frühwald M, Giangaspero F. Claudin-6 is of limited sensitivity and specificity for the diagnosis of atypical teratoid/rhabdoid tumors. Brain Pathol 2011; 21:558-63. [PMID: 21261775 DOI: 10.1111/j.1750-3639.2011.00478.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Recent gene expression microarray analyses have indicated that claudin-6 is specifically expressed in atypical teratoid rhabdoid tumors (AT/RTs), suggesting a role as a positive diagnostic marker in addition to SMARCB1 (INI1) loss, which is encountered in the majority of AT/RTs. In order to investigate the potential of claudin-6 as a diagnostic marker, expression was investigated in 59 AT/RTs and 60 other primary central nervous system (CNS) tumors, including primitive neuroectodermal tumors, medulloblastomas, choroid plexus tumors, and both pediatric and adult low- and high-grade gliomas using immunohistochemistry. Claudin-6 was expressed in 17/59 AT/RTs (29%), but also in a variety of other primary CNS tumors, including 60% of medulloblastomas and 21% of malignant gliomas. Even though high staining scores (2+ or 3+) were more often encountered in AT/RTs (Chi-square 4.177; P=0.041), the overall frequency of claudin-6 staining was not significantly higher in AT/RTs as compared with the other tumors (17/59 vs. 16/60; Chi-square=0.328; P=0.567). In a subgroup of 43 AT/RT patients, of which follow-up data were available, claudin-6 expression did not show any correlation with survival. In conclusion, claudin-6 immunohistochemistry is of limited sensitivity and specificity for the diagnosis of AT/RT and does not correlate with clinical behavior.
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Affiliation(s)
- Manila Antonelli
- Department of Radiology, Oncology and Anatomic-pathology Sciences, Sapienza University, Rome, Italy
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Mirow C, Walden U, Frühwald M. Pseudotumor cerebri und Hirnnervenausfällen als Manifestation einer Neuroborreliose. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mannfeld S, Walden U, Frühwald M. Akute nicht steinassoziierte Cholezystitis (AAC) als Hauptsymptom einer EBV-Primärinfektion. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Albrecht H, Frühwald M. Konsensus-Konferenz der Karl und Veronica Carstens-Stiftung: Placebo in der klinischen Forschung zur Homöopathie. Complement Med Res 2010. [DOI: 10.1159/000210116] [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: 11/19/2022]
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Nowacki M, Masjosthusmann K, Kerl K, Lohse K, Leuschner I, Hörnig-Franz I, Frühwald M. Perinatale Asphyxie und hämorrhagischer Schock durch Ruptur eines kongenitalen Tumors. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bauer J, Masjosthusmann K, Berghäuser MA, Werner C, Rössig C, Frühwald M. Methoden zur Energie- und Nährstoffbilanzierung bei Kindern nach hämatopoetischer Stammzelltransplantation. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1223016] [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: 10/20/2022]
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Rutkowski S, Fleischhack G, Gnekow A, Kramm C, Müller H, Calaminus G, Wrede B, Frühwald M, Krauss J, Faldum A, Kortmann R, Pietsch T, Warmuth-Metz M. Hirntumoren bei Kindern und Jugendlichen. Monatsschr Kinderheilkd 2008. [DOI: 10.1007/s00112-008-1801-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Reinhard H, Reinert J, Beier R, Furtwängler R, Alkasser M, Rutkowski S, Frühwald M, Koscielniak E, Leuschner I, Kaatsch P, Graf N. Rhabdoid tumors in children: Prognostic factors in 70 patients diagnosed in Germany. Oncol Rep 2008. [DOI: 10.3892/or.19.3.819] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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