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  • 1
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    Abstract A57: Feasibility of physical activity in children with cancer: A multidisciplinary program in the context of the VIE study
    American Association for Cancer Research (AACR) ; 2020
    In:  Cancer Research Vol. 80, No. 14_Supplement ( 2020-07-15), p. A57-A57
    Details
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 80, No. 14_Supplement ( 2020-07-15), p. A57-A57
    Abstract: Purpose: Cancer is one of the leading causes of death in the world. The physiologic and psychological benefits of physical activity have been shown in children with cancer. However, almost one in two cancer patients do not follow the physical activity guidelines. The aim of this study will be to assess the feasibility of a physical activity program intervention in pediatric oncology and to assess the barriers and facilitators in the success or failure of this physical activity program. Methods: The VIE (Valorization, Implication and Education) intervention is a multidisciplinary program including physical activity, nutritional, and psychological interventions in pediatric oncology. This study involves one intervention group that will be followed over two years (evaluations and physical activity interventions) and one control group that will participate in only one evaluation. The feasibility of this program will be measured through a comparison between sessions performed and sessions scheduled, while the security will be measured according to the number of reported incidents. Preliminary Results: An adhesion rate of about 40% despite restrictions and organizational conflicts specific to the hospital context was reported. A minor incident in 1 of 278 sessions performed with 35 children with cancer was observed. Conclusion: This study is the first to examine the effects of exercise in pediatric oncology, from diagnosis to the expected end of treatment. At this time, our findings show the feasibility of this physical activity program in a safe context. This is an important study in the exercise and oncology field to help patients and their family during and after cancer treatments. Citation Format: Maxime Caru, Gabrielle Duhamel, Valérie Marcil, Serge Sultan, Caroline Meloche, Isabelle Bouchard, Simon Drouin, Laurence Bertout, Caroline Laverdière, Daniel Sinnett, Daniel Curnier. Feasibility of physical activity in children with cancer: A multidisciplinary program in the context of the VIE study [abstract]. In: Proceedings of the AACR Special Conference on the Advances in Pediatric Cancer Research; 2019 Sep 17-20; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Res 2020;80(14 Suppl):Abstract nr A57.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    URL: Article
    DOI: 10.1158/1538-7445.PEDCA19-A57
    RVK:
    XA 36000
    RVK:
    XA 10000
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
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  • 2
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    Abstract B59: Cardiometabolic complications after pediatric cancer: Associations with chemotherapeutic agents and body-mass-index fluctuations
    American Association for Cancer Research (AACR) ; 2020
    In:  Cancer Research Vol. 80, No. 14_Supplement ( 2020-07-15), p. B59-B59
    Details
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 80, No. 14_Supplement ( 2020-07-15), p. B59-B59
    Abstract: Introduction: Survivors of childhood cancer are at risk of cardiometabolic complications including dyslipidemia, obesity, insulin resistance, and hypertension. In addition, children undergoing chemotherapy often suffer from substantial side effects including rapid weight gain, transient hypertension, and elevated blood glucose and lipids. However, little is known about the cardiometabolic health of children shortly after cancer treatment. This study aims to describe the cardiometabolic profile of children after treatment and to study the factors associated with these complications. Methods: Participants were recruited at Sainte-Justine UHC in Montreal as part of the VIE Program (Valorization, Implication, Education). Cardiometabolic health was assessed with biochemical, clinical, and anthropometric measures. Data on treatment (diagnosis, chemotherapeutic agents, and doses) were obtained from medical files. Results: Evaluations were performed on 71 participants (45% boys; median age: 9.8 years; 42% with acute lymphoblastic leukemia; median time since last treatment: 1.4 years, range: 0.2-3.5 years). Our assessment showed that 28% had hypertension, 27% were obese, 19% had altered glucose metabolism, and 33% had dyslipidemia. The risk of having dyslipidemia was associated with higher age [relative risk (RR): 1.28, 95%CI: 1.14-1.44, P & lt;0.01] and body mass index (BMI) (RR: 1.76, 95%CI: 1.11-2.78, P=0.02). Participants who increased their BMI during treatment were at higher risk of obesity (RR: 3.01, 95%CI: 1.44-6.29, P & lt;0.01). The increase of BMI during treatment was associated with exposure to glucocorticoids (coefficient β: 0.56, 95%CI: 0.13-0.98, P=0.01) and to methotrexate (coefficient β: 0.73, 95%CI: 0.34-1.11, P & lt;0.01). Conclusion: We found important alterations of children’s cardiometabolic profile shortly after the end of cancer treatment. Increased BMI during and after treatment and exposure to corticosteroids and methotrexate were factors associated with cardiometabolic health. This stresses the importance of maintaining a favorable nutritional status during cancer therapy. Early nutritional interventions promoting sustainable healthy eating habits may contribute to limit cardiometabolic complications in the short and long term. Citation Format: Veronique Belanger, Alexandre Warin, Elitsa Tonova, Isabelle Bouchard, Caroline Meloche, Daniel Curnier, Serge Sultan, Caroline Laverdiere, Daniel Sinnett, Valerie Marcil. Cardiometabolic complications after pediatric cancer: Associations with chemotherapeutic agents and body-mass-index fluctuations [abstract]. In: Proceedings of the AACR Special Conference on the Advances in Pediatric Cancer Research; 2019 Sep 17-20; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Res 2020;80(14 Suppl):Abstract nr B59.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    URL: Article
    DOI: 10.1158/1538-7445.PEDCA19-B59
    RVK:
    XA 36000
    RVK:
    XA 10000
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
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  • 3
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    Abnormal HDL lipid and protein composition following pediatric cancer treatment: an associative study
    Springer Science and Business Media LLC ; 2023
    In:  Lipids in Health and Disease Vol. 22, No. 1 ( 2023-06-10)
    Details
    In: Lipids in Health and Disease, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2023-06-10)
    Abstract: Long-term childhood cancer survivors (CCS) are at high risk of having dyslipidemia including low high density lipoprotein cholesterol (HDL-C). However, little is known about the prevalence of low HDL-C and the impact of therapy exposure on HDL composition early after treatment is terminated. Methods This associative study included 50 children and adolescents who had completed their cancer treatments ( 〈  4 years). Clinical characteristics (demographic, diagnosis, treatment, anthropometric parameters), fasting plasma lipids, apoliporoteins (Apo) A-I and composition of HDL fractions (HDL2 and HDL3) were assessed. Data were stratified according to the presence of dyslipidemia and median doses of therapeutic agents and compared using Fisher exact or Mann–Whitney tests. Univariate binary logistic regression analyses were carried out to evaluate the associations between the clinical and biochemical characteristics and having low HDL-C. Composition of HDL2 and HDL3 particles was assessed in a sub-group of 15 patients and compared to 15 age- and sex-matched healthy controls using Wilcoxon paired test. Results Of the 50 pediatric cancer patients included in this study (mean age: 11.30 ± 0.72 y; mean time since end of treatment: 1.47 ± 0.12 y; male: 38%), 8 had low HDL-C (16%), all of which were adolescent at diagnosis. Higher doses of doxorubicin were associated with lower HDL-C and Apo A-I levels. In hypertriglyceridemic patients and compared to normolipidemics, triglycerides (TG) content was greater in HDL2 and HDL3 fractions whereas esterified cholesterol (EC) content was lower in HDL2. Enrich TG content of HDL3 and lower EC of HDL2 was found in patients exposed to ≥ 90 mg/m 2 doxorubicin. Factors positively associated with the risk of having low HDL-C were age, being overweight or obese and exposure to doxorubicin ≥ 90 mg/m 2 . Compared to healthy controls, a sub-group of 15 patients showed higher TG and free cholesterol (FC) content of HDL2 and HDL3 and lower EC content in HDL3. Conclusions Overall, we found abnormalities in HDL-C and Apo A-I levels and in HDL composition early after pediatric cancer treatment that are influenced by age, overweight or obesity status and exposure to doxorubicin.
    Type of Medium: Online Resource
    ISSN: 1476-511X
    URL: Article
    DOI: 10.1186/s12944-023-01822-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 4
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    Needs, Barriers and Facilitators of Adolescents Participating in a Lifestyle Promotion Program in Oncology: Stakeholders, Adolescents and Parents’ Perspective
    MDPI AG ; 2022
    In:  Children Vol. 9, No. 9 ( 2022-09-01), p. 1340-
    Details
    In: Children, MDPI AG, Vol. 9, No. 9 ( 2022-09-01), p. 1340-
    Abstract: Treatments for adolescent cancer can cause debilitating side effects in the short- and long-term such as nausea and malnutrition but also cardiometabolic disturbances. Although the risk for cardiometabolic complications is greater for adolescents with cancer than younger ones, adolescents typically respond poorly to family-oriented health promotion programs. This study aims to assess the needs, barriers and facilitators to healthy lifestyle promotion interventions for adolescents with cancer and how to best adapt these interventions for them. Interviews were held with adolescents treated for cancer (n = 9) and parents (n = 6), focus groups were conducted with stakeholders working in oncology (n = 12) and self-report questionnaires were sent to stakeholders involved in a health promotion intervention (n = 6). At the time of interview, mean age of adolescent participants (40% female) was 17.0 ± 1.9 years (mean age at diagnosis: 14.6 ± 1.6 years). Verbatim and responses to questionnaires were coded and analyzed using qualitative methods. Stakeholder stated that adolescents with cancer need to access activities adapted to their age, to communicate with peers going through a similar experience, and to preserve their schooling and friendships. Barriers to intervention reported by adolescents, parents and stakeholders include lack of motivation, schedule conflicts, fatigue and treatment side effects. Some of the barriers mentioned by adolescents and parents include pain, post-surgery problems, school, physical deconditioning, and lack of time. Facilitators mentioned by adolescents and parents comprise trust in stakeholders’ expertise, personalized approaches, scheduling flexibility. Stakeholders recommended to build trust in the relationship, favoring non-moralizing teachings, adapt interventions to adolescents’ limited attention span and avoiding the use of long-term health benefits as a motivator.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    URL: Article
    DOI: 10.3390/children9091340
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 5
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    Whole-transcriptome analysis in acute lymphoblastic leukemia: a report from the DFCI ALL Consortium Protocol 16-001
    American Society of Hematology ; 2022
    In:  Blood Advances Vol. 6, No. 4 ( 2022-02-22), p. 1329-1341
    Details
    In: Blood Advances, American Society of Hematology, Vol. 6, No. 4 ( 2022-02-22), p. 1329-1341
    Abstract: The molecular hallmark of childhood acute lymphoblastic leukemia (ALL) is characterized by recurrent, prognostic genetic alterations, many of which are cryptic by conventional cytogenetics. RNA sequencing (RNA-seq) is a powerful next-generation sequencing technology that can simultaneously identify cryptic gene rearrangements, sequence mutations and gene expression profiles in a single assay. We examined the feasibility and utility of incorporating RNA-seq into a prospective multicenter phase 3 clinical trial for children with newly diagnosed ALL. The Dana-Farber Cancer Institute ALL Consortium Protocol 16-001 enrolled 173 patients with ALL who consented to optional studies and had samples available for RNA-seq. RNA-seq identified at least 1 alteration in 157 patients (91%). Fusion detection was 100% concordant with results obtained from conventional cytogenetic analyses. An additional 56 gene fusions were identified by RNA-seq, many of which confer prognostic or therapeutic significance. Gene expression profiling enabled further molecular classification into the following B-cell ALL (B-ALL) subgroups: high hyperdiploid (n = 36), ETV6-RUNX1/-like (n = 31), TCF3-PBX1 (n = 7), KMT2A-rearranged (KMT2A-R; n = 5), intrachromosomal amplification of chromosome 21 (iAMP21) (n = 1), hypodiploid (n = 1), Philadelphia chromosome (Ph)-positive/Ph-like (n = 16), DUX4-R (n = 11), PAX5 alterations (PAX5 alt; n = 11), PAX5 P80R (n = 1), ZNF384-R (n = 4), NUTM1-R (n = 1), MEF2D-R (n = 1), and others (n = 10). RNA-seq identified 141 nonsynonymous mutations in 93 patients (54%); the most frequent were RAS-MAPK pathway mutations. Among 79 patients with both low-density array and RNA-seq data for the Philadelphia chromosome-like gene signature prediction, results were concordant in 74 patients (94%). In conclusion, RNA-seq identified several clinically relevant genetic alterations not detected by conventional methods, which supports the integration of this technology into front-line pediatric ALL trials. This trial was registered at www.clinicaltrials.gov as #NCT03020030.
    Type of Medium: Online Resource
    ISSN: 2473-9529 , 2473-9537
    URL: Article
    DOI: 10.1182/bloodadvances.2021005634
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2022
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  • 6
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    Cardiometabolic Health After Pediatric Cancer Treatment: Adolescents Are More Affected than Children
    Informa UK Limited ; 2022
    In:  Nutrition and Cancer Vol. 74, No. 9 ( 2022-10-21), p. 3236-3252
    Details
    In: Nutrition and Cancer, Informa UK Limited, Vol. 74, No. 9 ( 2022-10-21), p. 3236-3252
    Type of Medium: Online Resource
    ISSN: 0163-5581 , 1532-7914
    URL: Article
    DOI: 10.1080/01635581.2022.2072908
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2022
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  • 7
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    The VIE study: feasibility of a physical activity intervention in a multidisciplinary program in children with cancer
    Springer Science and Business Media LLC ; 2020
    In:  Supportive Care in Cancer Vol. 28, No. 6 ( 2020-06), p. 2627-2636
    Details
    In: Supportive Care in Cancer, Springer Science and Business Media LLC, Vol. 28, No. 6 ( 2020-06), p. 2627-2636
    Type of Medium: Online Resource
    ISSN: 0941-4355 , 1433-7339
    URL: Article
    DOI: 10.1007/s00520-019-05085-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
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  • 8
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    Early Nutritional Intervention to Promote Healthy Eating Habits in Pediatric Oncology: A Feasibility Study
    MDPI AG ; 2022
    In:  Nutrients Vol. 14, No. 5 ( 2022-02-28), p. 1024-
    Details
    In: Nutrients, MDPI AG, Vol. 14, No. 5 ( 2022-02-28), p. 1024-
    Abstract: This study aims to describe the feasibility of a nutritional intervention that promotes healthy eating habits early after cancer pediatric diagnosis in patients and their parents. Participants were recruited 4 to 12 weeks after cancer diagnosis as part of the VIE study. The one-year nutritional intervention included an initial evaluation and 6 follow-up visits every 2 months with a registered dietician. The feasibility assessment included rates of retention, participation, attendance, completion of study measures, and participants’ engagement. A preliminary evaluation of the intervention's impact on the participants’ dietary intakes was conducted. A total of 62 participants were included in the study (51.6% male, mean age = 8.5 years, mean time since diagnosis = 13.2 weeks). The retention and attendance rates were 72.6% and 71.3%, respectively. Attendance to follow-up visits declined over time, from 83.9% to 48.9%. A majority of participants had high participation (50.8%) and high engagement (56.4%). Measures of body-mass-index or weight-for-length ratio and dietary 24-h recalls were the procedures with the highest completion rates. Participants with refractory disease or relapse were less likely to complete the intervention. Post-intervention, participants (n = 21) had a lower sodium intake compared to the initial evaluation. These results suggest that a nutritional intervention that involves patients and parents early after a pediatric cancer diagnosis is feasible.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu14051024
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 9
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    Improvement of Diet after an Early Nutritional Intervention in Pediatric Oncology
    MDPI AG ; 2023
    In:  Children Vol. 10, No. 4 ( 2023-03-31), p. 667-
    Details
    In: Children, MDPI AG, Vol. 10, No. 4 ( 2023-03-31), p. 667-
    Abstract: Pediatric cancer survivors may experience cardiometabolic sequelae over the course of their lives as a result of the treatments they have received. While nutrition consists of an actionable target for cardiometabolic health, few nutritional interventions have been documented in this population. This study assessed the changes in diet during a one-year nutritional intervention for children and adolescents undergoing cancer treatments and the participants’ anthropometric and cardiometabolic profiles. A total of 36 children and adolescents (mean age: 7.9 years, 52.8% male) newly diagnosed with cancer (50% leukemia) and their parents underwent a one-year individualized nutrition intervention. The mean number of follow-up visits with the dietitian during the intervention was 4.72 ± 1.06. Between the initial and one-year assessments, there was an improvement in diet quality reflected by the Diet Quality Index (5.22 ± 9.95, p = 0.003). Similarly, the proportion of participants with moderate and good adherence (vs. low adherence) to the Healthy Diet Index score almost tripled after one year of intervention (14% vs. 39%, p = 0.012). In parallel, there was an increase in the mean z-scores for weight (0.29 ± 0.70, p = 0.019) and BMI (0.50 ± 0.88, p = 0.002), and in the mean levels of HDL-C (0.27 ± 0.37 mmol/L, p = 0.002) and 25-hydroxy vitamin D (14.5 ± 28.1 mmol/L, p = 0.03). Overall, this study supports that a one-year nutritional intervention deployed early after a pediatric cancer diagnosis is associated with an improvement in the diets of children and adolescents.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    URL: Article
    DOI: 10.3390/children10040667
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
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  • 10
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    Ikaros Gene Deletion Significantly Predicts Relapse in Pediatric B-ALL Patients with Low End-Induction Minimal Residual Disease
    American Society of Hematology ; 2015
    In:  Blood Vol. 126, No. 23 ( 2015-12-03), p. 2613-2613
    Details
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 2613-2613
    Abstract: Background: Deletions in the Ikaros gene (IKZF1) have been associated with a poor outcome in pediatric B-ALL, but the interaction of IKZF1 deletions with other established prognostic factors, such as minimal residual disease (MRD), is still under investigation. Here we report the IKZF1 deletion status of 405 patients (pts) with acute lymphoblastic leukemia (ALL) and its association with other presenting features, end-induction MRD, and outcome. Methods: Between 2005-2011, 794 eligible pts (aged 1-18 yrs) with newly diagnosed pediatric ALL (B-ALL: 697; T-ALL: 97) were enrolled on DFCI ALL Consortium Protocol 05-001. End-induction MRD was assessed prospectively on all pts by allele-specific oligonucleotide-PCR assay. DNA was extracted from archived diagnostic blood or bone marrow samples from 399 B-ALL and 6 T-ALL pts with sufficient available material. Using a commercially available kit (SALSA MLPA P202 IKZF1, MRC-Holland), IKZF1 deletion status was assessed by multiplex ligation-dependent probe amplification (MLPA). Event free survival (EFS) and relapse free survival (RFS) were estimated using the method of Kaplan and Meier. Results: IKZF1 deletion was detected in 69 (17%) of the 405 evaluated pts. IKZF1 deletion was more common in pts over 10 years old (p 〈 0.0001), males (p=0.05), Hispanic/Latinos (p=0.002) and those with presenting white blood cell count (WBC) at diagnosis ≥ 50K/ul (p 〈 0.0001). IKZF1 deletions were detected in 7 of 13 (54%) pts with the Philadelphia chromosome (Ph+). Significantly more IKZF1 pts experienced induction failure (7% vs 1%, p=0.009) and relapse (25% vs 7%, p 〈 0.0001) than pts without IKZF1 deletions. There was no difference in rates of treatment-related mortality. With a median follow-up of 5.3 years, the 5-year event free survival (EFS) for patients without IKZF1 deletion was 87% and 61% for those with IKZF1 deletion (p 〈 0.0001; Figure 1). There was no significant difference in EFS based on type of IKZF1 deletion: 1) deletions of exons 4-7 or 4-8 (42% of cases, 5-yr EFS 51%) or 2) whole gene (49% of cases, 5-yr EFS 69%) (p=0.23). 315 Ph-negative B-ALL pts achieving complete remission (CR) had assessable end-induction MRD. Significantly more IKZF1 non-deleted pts had low MRD compared with IKZF1-deleted pts (95% vs 82%, p=0.006). For the 293 MRD-low pts, relapse occurred in 7% of IKZF1 non-deleted and 24% of IKZF1-deleted pts (p=0.004); for 22 MRD-high pts (all of whom received intensified therapy), there was no significant difference in relapse between IKZF1 non-deleted and IKZF1-deleted pts (21% vs 37%, p=0.62). The 5-yr relapse-free survival (RFS) was significantly worse for MRD-low pts with IKZF1 deletions versus those without these deletions (Figure 1). In multivariable analysis, IKZF1 status, but not MRD, was significantly associated with RFS for Ph-negative B-ALL pts. (Table 1) Conclusions: IKZF1 deletion is associated with higher rates of induction failure and relapse, and is a significant predictor of inferior outcome in pediatric B-ALL. IKZF1 deletion was associated with significantly higher rates of relapse in Ph-negative B-ALL patients with low end-induction MRD, and thus may be useful factor to consider when stratifying treatment intensity in this subset of pts. We conclude that IKZF1 deletion should be incorporated into risk stratification for pediatric B-ALL. Table 1. Prognostic Factors for RFS for B-ALL, Ph-negative pts with evaluable end-induction MRD Univariate Multivariable HR [95% CI] p-value HR [95% CI] p-value Age, ≥10 vs 〈 10 1.40 [0.68-2.91] 0.36 1.19 [0.56-2.51] 0.65 IKZF1, del vs. not 3.23 [1.61-6.45] 0.0009 2.53 [1.20-5.30] 0.01 MRD, high vs. low 2.51 [1.04-6.03] 0.04 1.63 [0.64-4.11] 0.30 WBC, ≥50 vs. 〈 50 2.50 [1.27-4.94] 0.008 1.99 [0.98-4.03] 0.06 [HR=Hazard ratio] Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V126.23.2613.2613
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
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