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1. An overview of disparities in childhood cancer: Report on the Inaugural Symposium on Childhood Cancer Health Disparities, Houston, Texas, 2016.

Author

Scheurer, Michael E, Lupo, Philip J, Schüz, Joachim, Spector, Logan G, Wiemels, Joseph L, Aplenc, Richard, Gramatges, M Monica, Schiffman, Joshua D, Pombo-de-Oliveira, Maria S, Yang, Jun J, Heck, Julia E, Metayer, Catherine, Orjuela-Grimm, Manuela A, Bona, Kira, Aristizabal, Paula, Austin, Mary T, Rabin, Karen R, Russell, Heidi V, and Poplack, David G

Subjects
Humans, Neoplasms, Risk Factors, Adolescent, Child, Child, Preschool, Infant, Infant, Newborn, Delivery of Health Care, Texas, Female, Male, Congresses as Topic, Disparities, health policy, pediatric oncology, Preschool, Newborn, Pediatric Research Initiative, Pediatric, Cancer, Oncology & Carcinogenesis, Cardiorespiratory Medicine and Haematology
Abstract

The Inaugural Symposium on Childhood Cancer Health Disparities was held in Houston, Texas, on November 2, 2016. The symposium was attended by 109 scientists and clinicians from diverse disciplinary backgrounds with interests in pediatric cancer disparities and focused on reviewing our current knowledge of disparities in cancer risk and outcomes for select childhood cancers. Following a full day of topical sessions, everyone participated in a brainstorming session to develop a working strategy for the continued expansion of research in this area. This meeting was designed to serve as a springboard for examination of childhood cancer disparities from a more unified and systematic approach and to enhance awareness of this area of need.

Published
2018

2. Rapid gene fusion testing using the NanoString nCounter platform to improve pediatric leukemia diagnoses in Sub-Saharan Africa.

Author

Gastier-Foster, Julie M., Lutwama, Fredrick, Mbabazi, Olive, Mlenga, Steven, Ulaya, Kennedy, Namazzi, Ruth, Hollingsworth, E. Faith, Lopez-Terrada, Dolores, Fisher, Kevin E., Roy, Angshumoy, Allen, Carl E., Poplack, David G., Mzikamanda, Rizine, Ozuah, Nmazuo, and Wasswa, Peter

Subjects
GENE fusion, CANCER diagnosis, CHILDHOOD cancer, PROTEIN-tyrosine kinase inhibitors, HIGH-income countries, MOLECULAR diagnosis
Abstract

Risk stratification andmolecular targeting have been key to increasing cure rates for pediatric cancers in high-income countries. In contrast, precise diagnosis in lowresource settings is hindered by insufficient pathology infrastructure. The Global HOPE program aims to improve outcomes for pediatric cancer in Sub-Saharan Africa (SSA) by building local clinical care and diagnostic capacity. This study aimed to assess the feasibility of implementing molecular assays to improve leukemia diagnoses in SSA. Custom NanoString nCounter gene fusion assays, previously validated in the US, were used to test samples from suspected leukemia patients. The NanoString platform was chosen due to relatively low cost, minimal technical and bioinformatics expertise required, ability to test sub-optimal RNA, and rapid turnaround time. Fusion results were analyzed blindly, then compared to morphology and flow cytometry results. Of 117 leukemia samples, 74 were fusion-positive, 30 were negative, 7 were not interpretable, and 6 failed RNA quality. Nine additional samples were negative for leukemia by flow cytometry and negative for gene fusions. All 74 gene fusions aligned with the immunophenotype determined by flow cytometry. Fourteen samples had additional information available to further confirm the accuracy of the gene fusion results. The testing provided a more precise diagnosis in >60% of cases, and 9 cases were identified that could be treated with an available tyrosine kinase inhibitor, if detected at diagnosis. As risk-stratified and targeted therapies become more available in SSA, implementing this testing in realtime will enable the treatment of pediatric cancer tomove toward incorporating risk stratification for optimized therapy. [ABSTRACT FROM AUTHOR]

Published
2024
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3. 64. Utilizing rapid molecular testing to reduce disparities in pediatric cancer in Sub-Saharan Africa

Author

Gastier-Foster, Julie, primary, Hollingsworth, Faith, additional, Lopez-Terrada, Dolores, additional, Fisher, Kevin, additional, Roy, Anshumoy, additional, Wasswa, Peter, additional, Ozuah, Nmazuo, additional, Mehta, Parth, additional, Lubega, Jospeh, additional, Allen, Carl, additional, Poplack, David, additional, and Lutwama, Fredrick, additional

Published
2023
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4. Addressing the childhood cancer crisis in sub-Saharan Africa

Author

Lubega, Joseph, Chirande, Lulu, Atwine, Barnabas, Davidson, Alan, Kashaigili, Heronima J, Kanyamuhunga, Aimable, Langat, Robert K, Munube, Deogratias, Mzikamanda, Rizine, Namazzi, Ruth, Nzamu, Irene, Akullo, Anne, Allen, Carl, Gastier-Foster, Julie M, Hockenberry, Marilyn, Ozuah, Nmazuo, Wasswa, Peter, Smith, Rachel, Wilson-Lewis, Kristi, and Poplack, David G

Published
2023
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7. Improving Childhood Cancer Survivor Care Through Web-Based Platforms

Author

Gramatges, M. Monica, de Nigris, Francesca Bonaduce, King, Jason, Horowitz, Marc E., Fordis, Michael, and Poplack, David G.

Subjects
Childhood cancer -- Care and treatment -- Patient outcomes -- Surveys, Cancer survivors -- Care and treatment -- Surveys, Patient compliance -- Surveys -- Management, E-health -- Methods -- Surveys, Continuum of care -- Methods -- Surveys, Cancer treatment, Cancer, Passports, Recurrence (Disease), Evidence-based medicine, Caregivers, Medical schools, Company business management, Health
Abstract

Survivors of childhood cancer are at increased risk for late effects of cancer therapy, but evidence suggests that adherence to follow-up care is suboptimal. Here, we review the barriers to adherence, including those unique to childhood cancer survivors, and the rationale for distribution of a survivorship care plan. We also discuss advantages and potential limitations of delivering survivorship care plans via web-based platforms, and describe the unique features of one of these platforms, Passport for Care. A baseline survey directed toward survivors and conducted through Passport for Care found that a significant proportion of survivors are unaware of their specific health risks resulting from cancer and its treatment, and compared with their parents, are less afraid of the risks of recurrence and of cancer therapy-associated late effects (n = 528). Web-based platforms such as Passport for Care have enormous potential for improving access to health information, as well as for enhancing patient, family caregiver, and healthcare provider awareness of both risks of late effects and recommended surveillance. Results from this survey also suggest the potential utility of leveraging these tools to conduct additional research on consenting survivors., Introduction In the United States, survival of childhood and adolescent cancer has increased significantly over the past several decades, from fewer than 50% of patients in the 1970s to more [...]

Published
2018

8. Radiation (and Medical) Biosurveillance : Screening Survivors for Late Effects of Therapy Using the Children’s Oncology Group Long-Term Follow-Up Guidelines

Author

Hudson, Melissa M., Landier, Wendy, Bhatia, Smita, Oeffinger, Kevin C., Sklar, Charles, Meadows, Anna, Horowitz, Marc, Poplack, David, Fordis, Michael, Constine, Louis S., Brady, L. W., editor, Heilmann, H. -P., editor, Molls, M., editor, Nieder, C., editor, Rubin, Philip, editor, Constine, Louis S., editor, Marks, Lawrence B., editor, and Okunieff, Paul, editor

Published
2008
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10. Abstract 1021: Custom gene fusion assay for the rapid diagnosis of pediatric cancer in Sub-Saharan Africa

Author

Gastier-Foster, Julie M., primary, Hollingsworth, E. Faith, additional, Lopez-Terrada, Dolores H., additional, Fisher, Kevin E., additional, Roy, Angshumoy, additional, Wasswa, Peter M., additional, Ozuah, Nmazuo W., additional, Mehta, Parth, additional, Lubega, Joseph, additional, Allen, Carl E., additional, Poplack, David G., additional, and Lutwama, Fredrick, additional

Published
2022
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14. Contributors

Author

Aaronson, Stuart A., primary, Abbruzzese, James L., additional, Abel, Erika L., additional, Acharyya, Swarnali, additional, Alobeid, Bachir, additional, Amengual, Jennifer, additional, Anderson, Kenneth C., additional, Barbash, Olena, additional, Bast,, Robert C., additional, Baylin, Stephen B., additional, Bertino, Joseph R., additional, Bhagat, Govind, additional, Bissell, Mina J., additional, Boerner, Scott A., additional, Bolden, Jessica E., additional, Borden, Ernest C., additional, Brock, Malcolm V., additional, Brown, Nelson E., additional, Califano, Andrea, additional, Calin, George Adrian, additional, Carroll, Peter R., additional, Chennubhotla, Chakra, additional, Choueiri, Toni K., additional, Corless, Christopher L., additional, Correia, Ana Luísa, additional, Critchley-Thorne, Rebecca, additional, Croce, Carlo Maria, additional, D’Andrea, Alan D., additional, Davidson, Nancy E., additional, Davis, April, additional, Deng, Changchun, additional, Diehl, J. Alan, additional, DiGiovanni, John, additional, Eder, Joseph Paul, additional, Ekmekcioglu, Suhendan, additional, Ernstoff, Marc S., additional, Faeder, James R., additional, Fearon, Eric R., additional, Finley, Lydia W.S., additional, Fisher, Susan, additional, Fletcher, Christopher D.M., additional, Ghajar, Cyrus M., additional, Glick, Adam B., additional, Gough, Albert, additional, Govindan, Ramaswamy, additional, Grandis, Jennifer R., additional, Gray, Joe W., additional, Green, Douglas R., additional, Greene, Kirsten L., additional, Grimm, Elizabeth A., additional, Grumolato, Luca, additional, Gu, Jian, additional, Guertin, David A., additional, Hahn, William C., additional, Hait, William N., additional, Havrda, Matthew C., additional, Hedberg, Matthew L., additional, Herbst, Roy S., additional, Hinds, Philip W., additional, Hoehn, Daniela, additional, Howley, Peter M., additional, Hsieh, Andrew C., additional, Hwu, Patrick, additional, Israel, Mark A., additional, Jacks, Tyler, additional, Joyce, Johanna A., additional, Kaelin,, William G., additional, Kantarjian, Hagop, additional, Keith, Brian, additional, Kelly, Ronan, additional, Korkaya, Hasan, additional, Korn, W. Michael, additional, Kurzrock, Razelle, additional, Larsen, Jill E., additional, Lee, Adrian V., additional, Lee, J. Jack, additional, Letai, Anthony G., additional, Lezon, Timothy, additional, Li, Long-Cheng, additional, Li, Yan, additional, Lippman, Scott M., additional, Liu, Yong-Jun, additional, Lizée, Gregory, additional, Look, A. Thomas, additional, LoRusso, Patricia M., additional, Lowe, Scott W., additional, Malkin, David, additional, Mardis, Elaine R., additional, Margolin, Judith, additional, Massagué, Joan, additional, Matrisian, Lynn, additional, McCormick, Frank, additional, Mendelsohn, John, additional, Mills, Gordon B., additional, Minna, John D., additional, Mollapour, Mehdi, additional, Morgensztern, Daniel, additional, Murphy, Robert F., additional, Neckers, Len, additional, O’Connor, Owen A., additional, O’Donnell, Peter H., additional, Oesterreich, Steffi, additional, Pardoll, Drew, additional, Payne, Elspeth, additional, Poplack, David G., additional, Post, Sean M., additional, Quail, Daniela F., additional, Quintás-Cardama, Alfonso, additional, Rabin, Karen R., additional, Ratain, Mark J., additional, Reimann, Julie D.R., additional, Romero, Ignacio, additional, Rubin, Eric, additional, Ruggero, Davide, additional, Sabatini, David M., additional, Sawas, Ahmed, additional, Schafer, Eric S., additional, Schroff, Rachna T., additional, Sherman, Steven I., additional, Signoretti, Sabina, additional, Sikic, Branimir I., additional, Simon, M. Celeste, additional, Spellman, Paul T., additional, Stuart, Josh, additional, Surana, Rishi, additional, Tamguney, Tanja Meyer, additional, Taylor, D. Lansing, additional, Terán, Mario D., additional, Thompson, Craig B., additional, Tonon, Giovanni, additional, Weinberg, Robert A., additional, Weiner, Louis M., additional, Welch, Danny R., additional, White, Eileen, additional, Wicha, Max S., additional, Winslow, Monte M., additional, Witkowska, H. Ewa, additional, Wu, Xifeng, additional, and Yuspa, Stuart H., additional

Published
2015
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23. List of Contributing Authors

Author

Aaronson, Stuart A., primary, Abbruzzese, James L., additional, Abel, Erika L., additional, Anderson, Kenneth C., additional, Arrick, Bradley A., additional, Bafico, Anna, additional, Barbash, Olena, additional, Bast, Robert C., additional, Baylin, Stephen B., additional, Nebiyou Bekele, B., additional, Bertino, Joseph R., additional, Boerner, Scott A., additional, Bommer, Guido T., additional, Borden, Ernest C., additional, Buchstaller, Johanna M., additional, Buetow, Kenneth H., additional, Burman, Kenneth D., additional, Calin, George Adrian, additional, Campisi, Judith, additional, Caprioli, Richard M., additional, Carroll, Peter R., additional, Chaurand, Pierre, additional, Ashley Chi, Jen-Tsan, additional, Cleveland, John L., additional, Collins, Jerry M., additional, Cortes, Jorge, additional, Costello, Joseph F., additional, Cox, James D., additional, Maria Croce, Carlo, additional, D'Andrea, Alan D., additional, Davis, Darren W., additional, Deberardinis, Ralph J., additional, Demasi, Joseph, additional, Alan Diehl, J., additional, Digiovanni, John, additional, Dorsey, Frank C., additional, Egeblad, Mikala, additional, Ekmekcioglu, Suhendan, additional, Evelhoch, Jeffrey L., additional, Fearon, Eric R., additional, Febbo, Phillip G., additional, Feng, Zhaohui, additional, Fletcher, Christopher D.M., additional, Frankel, Arthur E., additional, Friedman, David B., additional, Fury, Matthew G., additional, Gambhir, Sanjiv Sam, additional, Gazdar, Adi F., additional, Girard, Luc, additional, Glick, Adam B., additional, Maria Gonzalez-Angulo, Ana, additional, Gray, Joe W., additional, Greene, Kirsten L., additional, Grimm, Elizabeth A., additional, Grumolato, Luca, additional, Guertin, David A., additional, Hait, William N., additional, Havrda, Matthew C., additional, Hennessy, Bryan, additional, Herbst, Roy S., additional, Houghton, Alan N., additional, Houghton, Peter J., additional, Howley, Peter M., additional, Hu, Wenwei, additional, Hwu, Patrick, additional, Israel, Mark A., additional, Jacks, Tyler, additional, Jorgensen, Claus, additional, Kantarjian, Hagop, additional, Keith, Brian, additional, Kelsen, David P., additional, Michael Korn, W., additional, Kundra, Priya, additional, Kurzrock, Razelle, additional, Jack Lee, J., additional, Levine, Arnold J., additional, Li, Long-Cheng, additional, Lippman, Scott M., additional, Littlepage, Laurie E., additional, Liu, Yong-Jun, additional, Look, Thomas, additional, Lorusso, Patricia M., additional, Malkin, David, additional, Margolin, Judith, additional, Matrisian, Lynn M., additional, Mccormick, Frank, additional, Mendelsohn, John, additional, Merghoub, Taha, additional, Mills, Gordon B., additional, Minna, John D., additional, Morrison, Sean J., additional, Morton, Christopher L., additional, Neckers, Len, additional, Nevins, Joseph R., additional, Okino, Steven T., additional, Pardoll, Drew M., additional, Pawson, Tony, additional, Payne, Elspeth, additional, Pfister, David G., additional, Polsky, David, additional, Poplack, David G., additional, Posada, Juan Gonzales, additional, Powis, Garth, additional, Quintana, Elsa, additional, Quintás-Cardama, Alfonso, additional, Rabin, Karen R., additional, Reimann, Julie D.R., additional, Rubin, Eric, additional, Sabatini, David M., additional, Sato, Mitsuo, additional, Sausville, Edward A., additional, Sen, Ganes, additional, Shah, Manish A., additional, Shames, David S., additional, Shoemaker, Robert H., additional, Sikic, Branimir I., additional, Silverman, Robert H., additional, Celeste Simon, M., additional, Spellman, Paul T., additional, Steeves, Meredith A., additional, Thompson, Craig B., additional, Tonon, Giovanni, additional, Weinberg, Robert A., additional, Welch, Danny R., additional, Werb, Zena, additional, Winslow, Monte M., additional, Woodward, Wendy A., additional, Xiong, Henry Q., additional, Yaghoubi, Shahriar S., additional, and Yuspa, Stuart H., additional

Published
2008
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25. Multidisciplinary Subspecialty Capacity Building for Global Pediatric Oncology

Author

Namazzi, Ruth, primary, Wasswa, Peter, additional, Mupere, Ezekiel, additional, Wilson-Lewis, Kristina, additional, Allen, Carl, additional, Kasirye, Philip, additional, Munube, Deogratias, additional, Nuchtern, Jed, additional, Airewele, Gladstone, additional, Chintagumpala, Murali, additional, Torrey, Susan, additional, Sekabira, John, additional, Poplack, David, additional, and Lubega, Joseph, additional

Published
2020
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34. Retinoblastoma Treatment

Author

Hurwitz, Richard L., Brenner, Malcolm K., Poplack, David G., and Horowitz, Marc C.

Published
1999

42. Dideoxyinosine in children with symptomatic human immunodeficiency virus infection

Author

Butler, Karina M., Husson, Robert N., Balis, Frank M., Brouwers, Pim, Eddy, Janie, El-Amin, Deborah, Gress, Janet, Hawkins, Mary, Jarosinski, Paul, Moss, Howard, Poplack, David, Santacroce, Shiela, Venzon, David, Wiener, Lori, Wolters, Pamela, and Pizzo, Philip A.

Subjects
Didanosine -- Dosage and administration, Didanosine -- Evaluation, AIDS (Disease) -- Drug therapy, HIV infection -- Drug therapy, AIDS (Disease) in children -- Drug therapy
Abstract

Dideoxyinosine (ddI), like zidovudine (AZT), was designed to inhibit the replication of retroviruses such as the AIDS virus. Unfortunately, such drugs are not perfect; not only is the inhibition of the virus far from total, but normal physiological processes are also affected, causing potentially serious side effects. However, although dideoxyinosine is very effective against the human immunodeficiency virus (HIV) in tissue culture experiments, its side effects seem to be milder than those of zidovudine. In a study of 43 children with symptomatic HIV infection, ddI was shown to be beneficial and to have relatively low toxicity. Sixteen of the children had been previously treated with zidovudine; ddI was effective in these cases as well. The children showed an increase in the number of CD4 lymphocytes in the blood and a decrease in the amount of the p24 viral antigen. Six patients died during the course of the study and one patient was taken off the drug regimen as his disease progressed. In addition, one patient was removed from the study due to toxicity of the ddI. The major toxicity observed was inflammation of the pancreas, which had been observed previously in trials of ddI among adults. During the course of the study, the levels of ddI in the blood were monitored, and it was found that the patients with higher blood levels tended to do better than patients with lower levels. This suggests that individual differences in the absorption of the drug in the intestine, or individual differences in the elimination of the drug, may be important in determining the response of the patient. It may be that customizing dosage procedures to the individual patient may result in a greater degree of effectiveness when treating HIV infection with dideoxyinosine. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

46. Phase II evaluation of topotecan for pediatric central nervous system tumors

Author

Blaney, Susan M., Phillips, Peter C., Packer, Roger J., Heideman, Richard L., Berg, Stacey L., Adamson, Peter C., Allen, Jeffrey C., Sallan, Stephen E., Jakacki, Regina I., Lange, Beverly J., Reaman, Gregory H., Horowitz, Marc E., Poplack, David G., and Balis, Frank M.

Subjects
Brain tumors, Alkaloids -- Health aspects, Antineoplastic agents -- Evaluation, Health
Published
1996

47. Variability in the oral bioavailability of all-trans-retinoic acid

Author

Adamson, Peter C., Pitot, Henry C., Balis, Frank M., Rubin, Joseph, Murphy, Robert F., and Poplack, David G.

Subjects
Tretinoin -- Physiological aspects, Drugs -- Bioavailability, Health
Abstract

Background: Orally administered all-trans-retinoic acid (all-trans-RA) can induce complete remission in a high proportion of patients with acute promyelocytic leukemia. A previous pharmacokinetic study in patients with acute promyelocytic leukemia raised the possibility that the absorption of orally administered all-trans-RA is a saturable process that would have significant clinical impact on dosing strategies. Purpose: This study was specifically designed to examine the saturability of all-trans-RA absorption by measuring the effect of doubling the oral dose of all-trans-RA on plasma drug concentration in patients receiving long-term oral therapy. Methods: Six patients with solid tumors received oral doses of 10-mg gelatin capsules of all-trans-RA. Patients were studied on 2 consecutive days after they received 28 days of all-trans-RA administered as two daily 78-mg/[m.sup.2] doses. The study assigned the patients to two groups. Three patients took a 156-mg/[m.sup.2] dose on day 28 and a 78-mg/[m.sup.2] dose on day 29; the other three patients took the lower dose on day 28 and the double dose on day 29. Blood samples for the determination of all-trans-RA plasma concentration were obtained at 30-minute intervals starting just prior to drug administration and continuing for a total of 7 hours. The plasma concentration of all-trans-RA was measured by high-performance liquid chromatography. Results: Plasma concentrations following an oral dose of all-trans-RA were highly variable, with peak concentrations ranging from 0.07 to 1.2 [Mu]M for the 78-mg/ [m.sup.2] dose level. Doubling the dose from 78 to 156 mg/[m.sup.2] increased plasma concentration in all six patients, but the increase was unpredictable and not related to dose, ranging from less than a 1.2-fold to more than a 10-fold increase. Conclusion: The current study does not support the hypothesis that the gastrointestinal absorption of all-trans-RA involves a saturable process but instead suggests that absorption is highly variable among patients. This wide interpatient variability suggests that pharmacokinetic drug monitoring may have an important role in the management of patients receiving all-trans-RA. [J Natl Cancer Inst 85:993-996, 1993]

Published
1993

48. Dose-dependent pharmacokinetics of all-trans-retinoic acid

Author

Adamson, Peter C., Balis, Frank M., Smith, Malcolm A., Murphy, Robert F., Godwin, Karen A., and Poplack, David G.

Subjects
Tretinoin -- Physiological aspects, Dose-response relationship (Biochemistry) -- Research, Pharmacokinetics -- Research, Health
Abstract

Background: Orally administered all-trans-retinoic acid (all-trans-RA) can induce remission in a high proportion of patients with acute promyelocytic leukemia. Purpose: To further define the drug's pharmacokinetics, a study of intravenous all-trans-RA was performed in rhesus monkeys. Methods: A total of nine monkeys received intravenous bolus injections of all-trans-RA. Three different doses (20, 50, and 100 Mg/[m.sub.2]) were each tested in three monkeys. Blood samples for determination of all-trans-RA concentration were obtained prior to drug administration and at 5, 10, 15, 30, 45, 60, 75, 90, 120, 150, 180, 240, 360, and 480 minutes after drug administration. Results: Plasma disappearance of all-trans-RA was characterized by three distinct phases: a brief, initial exponential decline, followed by a relative plateau in the disappearance curve (the duration of which was dose dependent), and finally a terminal exponential decay. This profile is consistent with a capacity-limited (saturable) elimination process. The first-order (terminal) half-life for all-trans-RA averaged 19 minutes, and the mean clearances were 77, 52, and 59 mL/min for the 20-, 50-, and 100-mg/[m.sub.2] dose groups, respectively. The mean [+ or -] SD Michaelis constant ([K.sup.m]) for the capacity-limited process was 3.2 [+ or -] 1.9 [Mu.M]. Conclusions: Peak plasma concentrations following oral administration of 45 mg/[m.sub.2] all-trans-RA in humans approach the [K.sup.m] for the capacity-limited process; thus, the dose-dependent pharmacokinetics of all-trans-RA described here may occur within the clinically used dosage range. [J Natl Cancer Inst 84:1332-1335, 1992]

Published
1992

50. Effect of continuous-infusion zidovudine therapy on neuropsychologic functioning in children with symptomatic human immunodeficiency virus infection

Author

Brouwers, Pim, Moss, Howard, Wolters, Pam, Eddy, Janie, Balis, Frank, Poplack, David G., and Pizzo, Philip A.

Subjects
Central nervous system, HIV infection -- Complications, Zidovudine -- Evaluation, Neuropsychological tests for children -- Evaluation, AIDS (Disease) in children -- Psychological aspects, AIDS (Disease) in children -- Complications, Health
Abstract

When children become infected with the human immunodeficiency virus (HIV), they often develop behavioral and cognitive (mental) disorders as well as neurological impairment resulting from encephalopathy (brain disease caused by HIV infection). Zidovudine, or AZT (azidothymidine, the only drug currently approved for treating HIV infection), has been shown to lead to improved cognitive and neurodevelopmental function in HIV-infected children. To learn more concerning this issue, 13 children experiencing symptoms of HIV infection underwent neuropsychologic testing before AZT therapy (administered continuously via an indwelling catheter), and again 6 and 12 months later. Eight were diagnosed as encephalopathic; the average age for all patients was six years, although the range of ages was considerable (14 months to 12 years). The initial study group included 21 children, four of whom died before 6 months had elapsed, and four of whom had toxic effects from AZT. For the remaining 13 subjects, marked improvements in cognitive function were seen after drug treatment. These included an average increase of 15.5 IQ points at both the 6- and 12-month follow-up periods, which was similar for patients with and without encephalopathy. Scores on other cognitive tests improved for eight patients, some of whom were encephalopathic. Adaptive behavior (including communication, daily living, and socialization skills) increased after treatment, although children with encephalopathy scored lower on these scales than those without encephalopathy. The improvements noted were similar for children who had acquired HIV infection in utero and via blood transfusion. Such patients need regular assessment to determine when the central nervous system is affected, so that appropriate treatment can be started. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

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