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Article ; Online: Cystatin C Based Equation Accurately Estimates Glomerular Filtration Rate in Children With Solid and Central Nervous System Tumours: Enough Evidence to Change Practice?

Dodgshun, Andrew J / Quinlan, Catherine / Sullivan, Michael J

2016 Volume 63, Issue 9, Page(s) 1535–1538

Abstract: Background: Assessing the glomerular filtration rate (GFR) of paediatric patients receiving nephrotoxic chemotherapy is a vital element of clinical practice. Isotopically measured GFR is the gold standard in terms of accuracy but requires injection of ... ...

Abstract	Background: Assessing the glomerular filtration rate (GFR) of paediatric patients receiving nephrotoxic chemotherapy is a vital element of clinical practice. Isotopically measured GFR is the gold standard in terms of accuracy but requires injection of tracer followed by several hours of blood tests. Estimation of GFR using creatinine is widely used but inaccurate, and there is increasing concern regarding its usage for paediatric oncology patients. Cystatin C (CysC) based equations are increasingly used in other paediatric specialities to estimate GFR, and their usefulness in paediatric oncology practice is becoming evident. Methods: We assessed the renal function of children with solid tumours and CNS tumours receiving nephrotoxic chemotherapy over a 1-year period using paired CysC and isotopic GFR. Results: Fifty-six sets of measurements were reviewed with estimated GFR predicted using CysC-based and creatinine-based equations. The best performing equation was the 'new CKiD' equation, which estimated GFR within 30% of the measured GFR on 86% of occasions, outperforming the Schwartz equation. If estimated GFR using this equation was >100 ml/min/1.73 m(2) , all values of measured GFR were normal at >90 ml/min/1.73 m(2) , a category containing two-thirds of all measurements. Conclusions: The new CKiD equation predicts GFR in paediatric oncology patients with more accuracy than creatinine-based equations. When the estimated GFR is >100 ml/min/1.73 m(2) , isotopic GFR can be safely omitted.
MeSH term(s)	Adolescent ; Central Nervous System Neoplasms/physiopathology ; Child ; Child, Preschool ; Cystatin C/blood ; Female ; Glomerular Filtration Rate ; Humans ; Infant ; Male ; Neoplasms/physiopathology ; Prospective Studies
Chemical Substances	Cystatin C
Language	English
Publishing date	2016-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2131448-2
ISSN	1545-5017 ; 1545-5009
ISSN (online)	1545-5017
ISSN	1545-5009
DOI	10.1002/pbc.26043
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Article ; Online: The "hygiene hypothesis" in IBD.

Gearry, Richard B / Dodgshun, Andrew J

Journal of Crohn's & colitis

2012 Volume 6, Issue 8, Page(s) 869; author reply 870

MeSH term(s)	Colitis, Ulcerative/epidemiology ; Crohn Disease/epidemiology ; Female ; Humans ; Hygiene Hypothesis ; Male
Language	English
Publishing date	2012-09
Publishing country	England
Document type	Comment ; Letter
ZDB-ID	2390120-2
ISSN	1876-4479 ; 1873-9946
ISSN (online)	1876-4479
ISSN	1873-9946
DOI	10.1016/j.crohns.2012.04.010
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Article ; Online: Low rates of recurrence and slow progression of pediatric pilocytic astrocytoma after gross-total resection: justification for reducing surveillance imaging.

Dodgshun, Andrew J / Maixner, Wirginia J / Hansford, Jordan R / Sullivan, Michael J

Journal of neurosurgery. Pediatrics

2016 Volume 17, Issue 5, Page(s) 569–572

Abstract: OBJECTIVE Pilocytic astrocytomas (PAs) are common brain tumors in children. Optimal management of PA is gross-total resection (GTR), after which event-free survival (EFS) is excellent. The tempo of recurrences, when they do occur, is relatively sparsely ... ...

Abstract	OBJECTIVE Pilocytic astrocytomas (PAs) are common brain tumors in children. Optimal management of PA is gross-total resection (GTR), after which event-free survival (EFS) is excellent. The tempo of recurrences, when they do occur, is relatively sparsely reported, and there is no agreed upon surveillance recommendation for patients in this category. It has been suggested that surveillance MRI is performed too frequently and could be safely reduced in both frequency and duration. The authors conducted a retrospective review of pediatric patients with PA who underwent GTR at a single institution over an 18-year period and who had documented recurrences. METHODS All patients under 18 years of age who had undergone GTR of a PA between 1996 and 2013 were included in the study. Clinical, radiological, and tumor characteristics were recorded. RESULTS Sixty-seven patients met the criteria for GTR over the period studied. The 5-year EFS rate was 95% (95% CI 89%-100%) and overall survival was 100%. Recurrences showed a nonsignificant trend of occurring more commonly in patients with persistent nonenhancing FLAIR abnormalities after surgery, but there was no difference with regard to tumor location. All recurrences occurred before 3 years postresection, all were asymptomatic, and all patients were observed for at least one additional scan after the initial detection during routine surveillance MRI before further therapy was undertaken. CONCLUSIONS EFS and overall survival are excellent after GTR in this population with PAs. Progression after recurrence occurs slowly and is asymptomatic. A less intensive schedule of MRI surveillance in this group of patients would result in time and cost savings, without compromising safety. The authors suggest a schedule of 6 MRI scans to be obtained postoperatively, at 3-6 months, then at 1, 2, 3.5, and 5 years.
MeSH term(s)	Adolescent ; Astrocytoma/epidemiology ; Astrocytoma/pathology ; Astrocytoma/surgery ; Brain Neoplasms/epidemiology ; Brain Neoplasms/pathology ; Brain Neoplasms/surgery ; Child ; Child, Preschool ; Cost Savings ; Disease Progression ; Female ; Humans ; Infant ; Magnetic Resonance Imaging/economics ; Male ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology ; Neurosurgical Procedures/methods ; Population Surveillance/methods ; Retrospective Studies
Language	English
Publishing date	2016-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2015.9.PEDS15449
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Uk I Zs.135 -Pediatrics-: Show issues

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Article: Biallelic FANCD1/BRCA2 mutations predisposing to glioblastoma multiforme with multiple oncogenic amplifications.

Dodgshun, Andrew J / Sexton-Oates, Alexandra / Saffery, Richard / Sullivan, Michael J

Cancer genetics

2016 Volume 209, Issue 1-2, Page(s) 53–56

Abstract: Fanconi anaemia (FA) caused by biallelic mutation in FANCD1/BRCA2 is rare but carries a high risk of early onset cancer. Medulloblastoma is well described in this cohort but reports of other brain tumours are uncommon. The molecular profile of tumours ... ...

Abstract	Fanconi anaemia (FA) caused by biallelic mutation in FANCD1/BRCA2 is rare but carries a high risk of early onset cancer. Medulloblastoma is well described in this cohort but reports of other brain tumours are uncommon. The molecular profile of tumours from FA patients is not well reported. A glioblastoma multiforme (GBM) from a 3-year-old patient with FA and confirmed biallelic BRCA2 mutations was submitted for methylation analysis. This revealed strong clustering with the K27 mutation subgroup and copy number analysis showed gains of chromosomes 1q, 4q, part of 7q, part of 8q and 17q with resultant amplifications of MDM4, CDK6, MET, MYC and PPM1D (WIP1). We also describe for the first time the germline mutation in BRCA2 c.8057T > C resulting in p.Leu2686Pro in our patient with confirmed FA. Biallelic BRCA2 mutations have predisposed to an aggressive and universally fatal subtype of childhood GBM in our patient. Copy number alterations and multiple oncogenic amplifications may be secondary to inherent chromosomal instability and this raises the question of what role BRCA2 may play in the development of GBM in children without FA.
MeSH term(s)	BRCA2 Protein/genetics ; Brain Neoplasms/genetics ; Child, Preschool ; Gene Amplification ; Genes, BRCA2 ; Glioblastoma/genetics ; Humans ; Male ; Mutation
Chemical Substances	BRCA2 Protein ; BRCA2 protein, human
Language	English
Publishing date	2016-01
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599227-2
ISSN	2210-7762
ISSN	2210-7762
DOI	10.1016/j.cancergen.2015.11.005
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Article ; Online: Long-term visual outcome after chemotherapy for optic pathway glioma in children: Site and age are strongly predictive.

Dodgshun, Andrew J / Elder, James E / Hansford, Jordan R / Sullivan, Michael J

Cancer

2015 Volume 121, Issue 23, Page(s) 4190–4196

Abstract: Background: Optic pathway gliomas (OPGs) are commonly noted in pediatric oncology services. Radiotherapy is effective at controlling tumors, but has many undesirable late effects, especially in patients with neurofibromatosis. Chemotherapy is commonly ... ...

Abstract	Background: Optic pathway gliomas (OPGs) are commonly noted in pediatric oncology services. Radiotherapy is effective at controlling tumors, but has many undesirable late effects, especially in patients with neurofibromatosis. Chemotherapy is commonly used to preserve vision and delay or eliminate the need for radiotherapy. Despite visual threat being a common reason to initiate chemotherapy in patients with OPG, reports of visual outcome after chemotherapy are not common and reports of long-term visual outcome are even scarcer. Methods: In a single institution, all patients with OPG who had received chemotherapy or radiotherapy between 1996 and 2013 were identified from hospital databases. Visual, treatment, and radiological data were recorded. Categorized visual acuity was the primary outcome measure. Results: Of 43 patients identified, visual data were available for 42 patients. Approximately 14% of patients experienced an improvement in visual acuity during therapy, 9% of patients experienced a deterioration, and the remainder were stable. At a mean follow-up of 78 months, 26% of patients were legally blind. Children aged <2 years and patients with a chiasmatic/hypothalamic tumor site were overrepresented in this category. An intraconal location was predictive of poor visual outcome for that eye but was unilateral with normal vision in the contralateral eye. Conclusions: Risk factors for long-term visual deterioration are young age, chiasmatic/hypothalamic tumor site, and intraconal tumor site for the involved eye. The most common visual outcome for children with OPG after treatment with chemotherapy is stability. This stability is maintained over the long term for >90% of children without these risk factors.
MeSH term(s)	Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Carboplatin/therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Optic Nerve Glioma/drug therapy ; Optic Nerve Glioma/pathology ; Optic Nerve Glioma/radiotherapy ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Vincristine/therapeutic use ; Visual Acuity/drug effects ; Visual Acuity/radiation effects
Chemical Substances	Vincristine (5J49Q6B70F) ; Carboplatin (BG3F62OND5)
Language	English
Publishing date	2015-12-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1429-1
ISSN	1097-0142 ; 0008-543X ; 1934-662X
ISSN (online)	1097-0142
ISSN	0008-543X ; 1934-662X
DOI	10.1002/cncr.29649
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Article ; Online: Reply to Comment on: Carboplatin Hypersensitivity Reactions in Pediatric Low Grade Glioma Are Protocol Specific and Desensitization Shows Poor Efficacy.

Dodgshun, Andrew J / Hansford, Jordan R / Cole, Theresa / Choo, Sharon / Sullivan, Michael J

Pediatric blood & cancer

2016 Volume 63, Issue 1, Page(s) 175

MeSH term(s)	Antineoplastic Agents/adverse effects ; Carboplatin/adverse effects ; Central Nervous System Neoplasms/therapy ; Desensitization, Immunologic ; Drug Hypersensitivity/therapy ; Female ; Glioma/drug therapy ; Humans ; Male
Chemical Substances	Antineoplastic Agents ; Carboplatin (BG3F62OND5)
Language	English
Publishing date	2016-01
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	2131448-2
ISSN	1545-5017 ; 1545-5009
ISSN (online)	1545-5017
ISSN	1545-5009
DOI	10.1002/pbc.25747
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Article ; Online: Single agent carboplatin for pediatric low-grade glioma: A retrospective analysis shows equivalent efficacy to multiagent chemotherapy.

Dodgshun, Andrew J / Maixner, Wirginia J / Heath, John A / Sullivan, Michael J / Hansford, Jordan R

International journal of cancer

2016 Volume 138, Issue 2, Page(s) 481–488

Abstract: Pediatric low-grade gliomas (LGG) that are unresectable often require adjuvant chemotherapy such as carboplatin/vincristine. Small Phase II studies have suggested equivalent efficacy of single agent 4-weekly carboplatin. A single-institution ... ...

Abstract	Pediatric low-grade gliomas (LGG) that are unresectable often require adjuvant chemotherapy such as carboplatin/vincristine. Small Phase II studies have suggested equivalent efficacy of single agent 4-weekly carboplatin. A single-institution retrospective review captured all patients aged 0 to 18 years diagnosed with LGG between 1996 and 2013 and treated with carboplatin monotherapy. The response and survival according to tumor site was compared to published results for multiagent chemotherapy. Of 268 children diagnosed with LGG diagnosed in this period, 117 received chemotherapy and 104 children received single agent carboplatin as first line chemotherapy. All patients received carboplatin at 560 mg/m(2), four-weekly for a median of 12 courses. The mean age at diagnosis was 5.8 years (range 3m-16y) and 32% had neurofibromatosis type 1. With a mean followup of 54 months, 86% of patients achieved stabilisation or better (SD/PR/CR). 3-year progression free survival (PFS) 66% (95% CI 57-76%), and 5-year PFS was 51% (95% CI 41-63%). 5-year overall survival was 97%. Multivariate analysis showed poorer PFS for those with chiasmatic/hypothalamic tumors. In this retrospective analysis single agent carboplatin shows comparable efficacy to historical multiagent chemotherapy for the treatment of patients with unresectable LGG. Equivalent outcomes are achieved with less chemotherapy, reduced side effects and fewer hospital visits. Further research is required to establish the place of this simplified regimen in the up-front treatment of unresectable LGG.
MeSH term(s)	Adolescent ; Antineoplastic Agents/therapeutic use ; Brain Neoplasms/drug therapy ; Brain Neoplasms/mortality ; Brain Neoplasms/pathology ; Carboplatin/therapeutic use ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Glioma/drug therapy ; Glioma/mortality ; Glioma/pathology ; Humans ; Infant ; Infant, Newborn ; Kaplan-Meier Estimate ; Male ; Neoplasm Grading ; Retrospective Studies ; Treatment Outcome
Chemical Substances	Antineoplastic Agents ; Carboplatin (BG3F62OND5)
Language	English
Publishing date	2016-01-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	218257-9
ISSN	1097-0215 ; 0020-7136
ISSN (online)	1097-0215
ISSN	0020-7136
DOI	10.1002/ijc.29711
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Zs.A 478: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Pediatric Pleomorphic Xanthoastrocytoma Treated With Surgical Resection Alone: Clinicopathologic Features.

Dodgshun, Andrew J / Sexton-Oates, Alexandra / Saffery, Richard / MacGregor, Duncan / Sullivan, Michael J

Journal of pediatric hematology/oncology

2016 Volume 38, Issue 7, Page(s) e202–6

Abstract: Pleomorphic xanthoastrocytoma (PXA) is a rare brain tumor that usually occurs in children and young adults. It has characteristic histologic features and is regarded as a WHO grade II lesion. Overall survival is reported to be >60%, but published series ... ...

Abstract	Pleomorphic xanthoastrocytoma (PXA) is a rare brain tumor that usually occurs in children and young adults. It has characteristic histologic features and is regarded as a WHO grade II lesion. Overall survival is reported to be >60%, but published series usually consist of a range of ages and treatment modalities. Gross total resection is associated with superior survival but recurrence rates after gross total resection are not well described, particularly in a pediatric population. We describe 16 cases over 20 years at our institution of pediatric PXA treated with surgical resection alone with a 5-year relapse-free survival of 40% (95% confidence interval, 20%-82%) and overall survival of 76% (95% confidence interval, 55%-100%). Gross total resection was associated with superior relapse-free survival (P<0.05). Some cases have a very long period between symptom onset or radiologic detection and resection, but neither length of symptoms nor radiologic signs of slow growth were associated with survival. PXA is a rare and unusual entity with unpredictable behavior. Complete surgical resection is optimal but does not guarantee relapse-free survival. We propose separation of PXA from other low-grade gliomas in childhood given differing biology and behavior.
MeSH term(s)	Adolescent ; Astrocytoma/mortality ; Astrocytoma/pathology ; Astrocytoma/surgery ; Brain Neoplasms/mortality ; Brain Neoplasms/pathology ; Brain Neoplasms/surgery ; Child ; Child, Preschool ; Female ; Humans ; Male
Language	English
Publishing date	2016-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	1231152-2
ISSN	1536-3678 ; 1077-4114 ; 0192-8562
ISSN (online)	1536-3678
ISSN	1077-4114 ; 0192-8562
DOI	10.1097/MPH.0000000000000581
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Article ; Online: Carboplatin Hypersensitivity Reactions in Pediatric Low Grade Glioma Are Protocol Specific and Desensitization Shows Poor Efficacy.

Dodgshun, Andrew J / Hansford, Jordan R / Cole, Theresa / Choo, Sharon / Sullivan, Michael J

Pediatric blood & cancer

2016 Volume 63, Issue 1, Page(s) 17–20

Abstract: Background: The use of carboplatin for the treatment of pediatric low grade gliomas (PLGG) is often limited by the development of carboplatin hypersensitivity. Reported rates of carboplatin hypersensitivity reactions vary between 6% and 32% in these ... ...

Abstract	Background: The use of carboplatin for the treatment of pediatric low grade gliomas (PLGG) is often limited by the development of carboplatin hypersensitivity. Reported rates of carboplatin hypersensitivity reactions vary between 6% and 32% in these patients. Here we report the frequency of carboplatin hypersensitivity reactions depending on the treatment regimen used, and outcomes of carboplatin desensitization. Methods: The records of all patients in a single institution who were treated with carboplatin for PLGG were accessed and all patients receiving more than one dose of carboplatin are reported. Results: Thirty four patients with PLGG were treated with carboplatin according to one of the two different regimens. Carboplatin hypersensitivity was documented in 47% of patients, but the frequency differed by treatment protocol. Those patients treated with 4-weekly single agent carboplatin had carboplatin allergy in 8% of cases whereas 68% of those treated with combined carboplatin and vincristine (every three weeks, according to the SIOP 2004 low grade glioma protocol) had carboplatin reactions (OR 23.6, P < 0.01). Desensitization was only successful in two out of 10 patients in whom it was attempted. Conclusions: Hypersensitivity reactions to carboplatin are more common in this cohort than previously reported and rates are protocol-dependent. Desensitization showed limited effectiveness in this cohort.
MeSH term(s)	Adolescent ; Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents, Phytogenic/administration & dosage ; Carboplatin/administration & dosage ; Carboplatin/adverse effects ; Central Nervous System Neoplasms/therapy ; Child ; Child, Preschool ; Desensitization, Immunologic ; Drug Hypersensitivity/therapy ; Female ; Glioma/drug therapy ; Humans ; Infant ; Male ; Neoplasm Grading ; Treatment Failure ; Vincristine/administration & dosage
Chemical Substances	Antineoplastic Agents ; Antineoplastic Agents, Phytogenic ; Vincristine (5J49Q6B70F) ; Carboplatin (BG3F62OND5)
Language	English
Publishing date	2016-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2131448-2
ISSN	1545-5017 ; 1545-5009
ISSN (online)	1545-5017
ISSN	1545-5009
DOI	10.1002/pbc.25686
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Article ; Online: Enrollment in clinical cancer trials: how are we doing and what are the obstacles to improving enrollment rates? A 2-year retrospective review of pediatric cancer trial enrollment in New Zealand.

Dodgshun, Andrew J / De Silva, Mandy P / Bradbeer, Peter / Cross, Siobhan

Journal of pediatric hematology/oncology

2014 Volume 36, Issue 8, Page(s) 630–634

Abstract: Clinical trials contribute to the establishment of the best therapy for children with cancer. This study looks at rates of enrollment in therapeutic clinical trials over a 2-year period in New Zealand and examines the reasons for nonenrollment. All new ... ...

Abstract	Clinical trials contribute to the establishment of the best therapy for children with cancer. This study looks at rates of enrollment in therapeutic clinical trials over a 2-year period in New Zealand and examines the reasons for nonenrollment. All new diagnoses of cancer in children aged 16 or younger over the period of 1 January, 2009 to 31 December, 2010 were identified through the New Zealand Child Cancer Registry. Clinical trial enrollment status was identified from the medical records. For those not enrolled, the reason for nonenrollment was ascertained. A total of 28% of children diagnosed with cancer who received chemotherapy with curative intent in this time period were enrolled on clinical trials. The 2 most common reasons for nonenrollment in this study were that no study was open locally in which to enroll children (27%) or that previously open-clinical trials were closed to accrual at the time of the child's diagnosis (20%). In New Zealand, enrollment rates on clinical trials for children with cancer are lower than expected.
MeSH term(s)	Adolescent ; Antineoplastic Agents/therapeutic use ; Child ; Clinical Trials as Topic/statistics & numerical data ; Clinical Trials as Topic/trends ; Humans ; Neoplasms/drug therapy ; New Zealand ; Parents/psychology ; Patient Compliance/psychology ; Patient Compliance/statistics & numerical data ; Patient Participation/psychology ; Patient Participation/statistics & numerical data ; Patient Participation/trends ; Registries/statistics & numerical data ; Retrospective Studies ; Young Adult
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2014-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	1231152-2
ISSN	1536-3678 ; 1077-4114 ; 0192-8562
ISSN (online)	1536-3678
ISSN	1077-4114 ; 0192-8562
DOI	10.1097/MPH.0000000000000123
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