Publications by authors named "Winick N"

Background: B-cell acute lymphoblastic leukemia (B-cell ALL) is the most common childhood cancer. Despite a high overall cure rate, relapsed B-cell ALL remains a leading cause of cancer-related death among children. The addition of the bispecific T-cell engager molecule blinatumomab (an anti-CD19 and anti-CD3 single-chain molecule) to therapy for newly diagnosed standard-risk (as defined by the National Cancer Institute) B-cell ALL in children may improve outcomes.

View Article and Find Full Text PDF

Limited prognostic factors have been associated with overall survival (OS) post-relapse in childhood Acute Lymphoblastic Leukemia (ALL). Patients enrolled on 12 Children's Oncology Group frontline ALL trials (1996-2014) were analyzed to assess for additional prognostic factors associated with OS post-relapse. Among 16,115 patients, 2053 (12.

View Article and Find Full Text PDF

Objectives: Survivors of childhood B-acute lymphoblastic leukemia (B-ALL) are at risk for difficulties with attention and executive functioning (EF) as a late effect of treatment. The present study aimed to identify treatment and demographic factors associated with risk for difficulties with EF in youth treated for high-risk B-ALL.

Method: Children and adolescents with B-ALL treated on Children's Oncology Group (COG) protocol AALL0232 were randomized to high-dose or escalating-dose methotrexate (MTX), and either dexamethasone or prednisone during the induction phase.

View Article and Find Full Text PDF
Article Synopsis
  • Despite high cure rates for childhood acute lymphoblastic leukemia (ALL), it remains a major cause of cancer-related deaths in children, especially among those initially classified as standard-risk (SR).
  • Researchers analyzed genomic data from over 1,300 children with ALL to identify factors influencing relapse, focusing on comparing patients who relapsed against those who stayed in remission for five years.
  • Findings indicated that specific genomic subtypes and chromosomal alterations significantly affect relapse risk, highlighting the need for detailed genetic analysis to improve risk assessment and treatment strategies in childhood ALL.
View Article and Find Full Text PDF
Article Synopsis
  • Steroids play a key role in treating acute lymphoblastic leukaemia (ALL) in young patients, but can lead to serious neuropsychiatric symptoms (SRNS).
  • A study examined 1813 patients from 2000 to 2017, finding that 5.2% experienced significant SRNS, mainly during the early and intensification phases of treatment, with dexamethasone linked to 86% of cases.
  • The most common SRNS symptoms were psychosis, agitation, and aggression, and 87% of those affected received pharmacological treatment, highlighting the need for more awareness and research on managing SRNS in ALL therapy.
View Article and Find Full Text PDF

Purpose: Many children treated for ALL develop long-term neurocognitive impairments. Increased risk of these impairments is associated with treatment and demographic factors. Exposure to anesthesia is an additional possible risk factor.

View Article and Find Full Text PDF

Objective: Examine the influence of household income on health-related quality of life (HRQOL) among children with newly diagnosed acute myeloid leukemia (AML).

Design: Secondary analysis of data prospectively collected from pediatric patients receiving treatment for AML at 14 hospitals across the United States.

Exposure: Household income was self-reported on a demographic survey.

View Article and Find Full Text PDF
Article Synopsis
  • * A multivariable Cox model was developed using data from over 21,000 patients to predict relapse-free survival (RFS) and establish more precise risk groups through the COG Prognostic Index (PI).
  • * The PI effectively differentiates between low and high relapse risks and identifies specific subgroups within moderate and high-risk patients, potentially guiding more personalized treatment strategies based on their predicted outcomes.
View Article and Find Full Text PDF

Osteonecrosis is a significant toxicity of acute lymphoblastic leukemia (ALL) therapy. In retrospective analyses, superior event-free survival was noted among affected adolescents in an earlier trial. We prospectively assessed osteonecrosis incidence, characteristics, and risk factors in patients 1-30 years with newly diagnosed high-risk B-ALL on COG AALL0232.

View Article and Find Full Text PDF

Purpose: Patients with Down syndrome (DS) and B-ALL experience increased rates of relapse, toxicity, and death. We report results for patients with DS B-ALL enrolled on Children's Oncology Group trials between 2003 and 2019.

Methods: We analyzed data for DS (n = 743) and non-DS (n = 20,067) patients age 1-30 years on four B-ALL standard-risk (SR) and high-risk trials.

View Article and Find Full Text PDF

Chemotherapy-induced peripheral neuropathy (CIPN), a common condition in children with acute lymphoblastic leukemia, can be challenging to diagnose. Using data from Children's Oncology Group AALL0932 physical function study, we sought to determine if parent/guardian proxy-reported responses from the Pediatric Outcomes Data Collection Instrument could identify children with motor or sensory CIPN diagnosed by physical/occupational therapists (PT/OT). Four variables moderately discriminated between children with and without motor CIPN (c-index 0.

View Article and Find Full Text PDF

The early thymic precursor (ETP) immunophenotype was previously reported to confer poor outcome in T-cell acute lymphoblastic leukemia (T-ALL). Between 2009 and 2014, 1256 newly diagnosed children and young adults enrolled in Children's Oncology Group (COG) AALL0434 were assessed for ETP status and minimal residual disease (MRD) using flow cytometry at a central reference laboratory. The subject phenotypes were categorized as ETP (n = 145; 11.

View Article and Find Full Text PDF

Background: The unprecedented exodus of workers from the healthcare system is a patient safety crisis. Organizational compassion in health care is the proactive, systematic, and continuous identification, alleviation, and prevention of all sources of suffering.

Aims: This scoping review aimed to describe the evidence regarding the impact of organizational compassion on clinicians, identify gaps, and provide recommendations for future research.

View Article and Find Full Text PDF

Purpose: Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer diagnosis. Cognitive late effects develop in 20%-40% of ALL survivors, but the course of declines is unclear. The aim of this paper is to characterize cognitive functioning, and its association with patient-reported outcomes, early in treatment.

View Article and Find Full Text PDF

Background: Previous studies have identified racial and ethnic disparities in childhood acute lymphocytic leukaemia survival. We aimed to establish whether disparities persist in contemporaneous cohorts and, if present, are attributable to differences in leukaemia biology or insurance status.

Methods: Patients with newly diagnosed acute lymphocytic leukaemia in inpatient and outpatient centres in the USA, Canada, Australia, and New Zealand, aged 0-30 years, who had race or ethnicity data available, enrolled on eight completed Children's Oncology Group trials (NCT00103285, NCT00075725, NCT00408005, NCT01190930, NCT02883049, NCT02112916, NCT02828358, and NCT00557193) were included in this secondary analysis.

View Article and Find Full Text PDF
Article Synopsis
  • The study assessed how leukemic involvement in the central nervous system (CNS) affects the prognosis of newly diagnosed T-cell acute lymphoblastic leukemia (T-ALL) through two clinical trials (AALL0434 and AALL1231).
  • Outcomes indicated that patients with CNS-1 and CNS-2 had similar event-free and overall survival rates, while those with CNS-3 had significantly worse outcomes, despite some receiving cranial radiation therapy (CRT).
  • The research found that novel agents like nelarabine improved survival for those with CNS-3 status, but highlighted the need for new treatment strategies given the poor prognosis associated with CNS-3 involvement.
View Article and Find Full Text PDF

Importance: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Hepatotoxic effects, including hyperbilirubinemia and elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, are common during all phases of therapy and are linked to several chemotherapeutic agents, including asparaginase, mercaptopurine, and methotrexate.

Objective: To determine which genetic variants were associated with hyperbilirubinemia and elevated ALT and AST levels in children, adolescents, and young adults treated for ALL.

View Article and Find Full Text PDF

Background: Promoting physical activity soon after treatment for childhood cancer may benefit health because sedentary lifestyle during curative therapy may perpetuate physical and emotional complications. The primary goals of this study are to evaluate the effects of a 6-month web-based, rewards-based physical activity intervention on fitness, biomarkers of cardiometabolic health, inflammation, adipokine status, quality of life and school attendance, and determine if effect of intervention on markers of cardiometabolic health is mediated by changes in fitness. The primary outcome of interest is fitness (physiological cost index, six-minute walk test) measured at end of intervention.

View Article and Find Full Text PDF
Article Synopsis
  • Acute lymphoblastic leukemia (ALL) is the most common cancer in children, and a study of 2,754 patients reveals that despite a low mutation burden, each case typically has about four important genetic alterations.
  • Researchers identified 376 potential driver genes linked to various functions like gene regulation and cell processes, with many patients having unique gene changes associated with leukemia.
  • The study highlights a difference in mutation patterns between B-ALL subtypes, with certain genetic alterations having significant implications for prognosis and potential treatment strategies.
View Article and Find Full Text PDF