A5042278322- Acute Lymphoblastic Leukemia research
- Childhood Cancer Survivors' Quality of Life
- Hematopoietic Stem Cell Transplantation
- Neutropenia and Cancer Infections
- CAR-T cell therapy research
- Economic and Financial Impacts of Cancer
- Adolescent and Pediatric Healthcare
- Cancer Risks and Factors
- Acute Myeloid Leukemia Research
- Chronic Lymphocytic Leukemia Research
- Chronic Myeloid Leukemia Treatments
- Ethics in Clinical Research
- Health Systems, Economic Evaluations, Quality of Life
- Renal Transplantation Outcomes and Treatments
- Neuroblastoma Research and Treatments
- Healthcare Policy and Management
- Sepsis Diagnosis and Treatment
- Lymphoma Diagnosis and Treatment
- Cytomegalovirus and herpesvirus research
- Pharmaceutical studies and practices
- Complement system in diseases
- Child and Adolescent Health
- Immune Cell Function and Interaction
- Global Cancer Incidence and Screening
- Palliative Care and End-of-Life Issues
UCSF Benioff Children's Hospital
2018-2025
University of California, San Francisco
2018-2025
UCSF Helen Diller Family Comprehensive Cancer Center
2019-2025
Children's Hospital of Philadelphia
2015-2023
ENT and Allergy
2023
University of Pennsylvania
2004-2019
Lucile Packard Foundation for Childrens Health
2014
Stanford University
2011-2014
Center For Policy Research
2014
Pediatrics and Genetics
2014
Adult cancer disparities have been documented for decades and continue to persist despite clinical advancements in prevention, detection, treatment. Pediatric survival has improved significantly the United States past 5 over 80%; however, disparate outcomes among children adolescents with still affect many populations globally, including racial ethnic minorities, low socioeconomic status, residents of underserved areas. To achieve equitable all cancer, it is imperative that concerted...
Abstract The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes HCT approaches by donor adults with ALL in remission. primary objective was to compare overall survival (OS) among HCTs PTCy and HLA-matched sibling (MSD), 8/8 unrelated (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing MSD HCT,...
Whether social determinants of health are associated with survival in the context pediatric oncology-targeted immunotherapy trials is not known. We examined association between poverty and event-free (EFS) overall (OS) for children high-risk neuroblastoma treated targeted trials.We conducted a retrospective cohort study 371 GD2-targeted Children's Oncology Group trial ANBL0032 or ANBL0931 at Pediatric Health Information System center from 2005 to 2014. Neighborhood exposure was characterized...
Allogeneic hematopoietic cell transplantation (HCT) can be complicated by life-threatening organ toxicity and infection necessitating intensive care. Epidemiologic data have been limited single-center studies, poor database granularity, a lack of long-term survivors. To identify contemporary trends in care unit (ICU) use outcomes, we merged from the Center for International Blood Marrow Transplant Research Virtual Pediatric Systems databases. We identified 6995 pediatric patients with HCT...
Chimeric antigen receptor T cell (CAR-T) therapy is a promising approach to improve survival for children and adults with relapsed/refractory (r/r) B acute lymphoblastic leukemia (B-ALL), but these clinical trials might not be equally accessible patients of low socioeconomic status (SES) or from racial ethnic minority groups. We sought describe the sociodemographic characteristics pediatric adolescent young adult (AYA) enrolled in CAR-T compare those other r/r B-ALL. conducted multicenter...
Abstract There has been an increase in volume as well improvement overall survival (OS) after hematopoietic cell transplantation (HCT) for hematologic disorders. It is unknown if these changes have affected racial/ethnic minorities equally. In this observational study from the Center International Blood and Marrow Transplant Research of 79 904 autologous (auto) 65 662 allogeneic (allo) HCTs, we examined rates change autoHCT alloHCT over time trends OS 4 groups: non-Hispanic Whites (NHWs),...
The aim of this study was to explore the perspectives healthcare providers on advantages and disadvantages integrating HIV care services, including highly active antiretroviral therapy (HAART), into antenatal (ANC) clinics in rural Kenya. We conducted a qualitative using in-depth interviews thematic analysis; 36 from six health centres Nyanza Province, Kenya participated. Effects service included increased workload due incorporation specialised services ANC clinics. Providers observed that...
Abstract Black patients with acute myeloid leukemia (AML) experience higher mortality than White patients. We compared induction mortality, acuity of illness prior to chemotherapy, and insurance type between assess whether presentation mediates the disparity. Within a retrospective cohort 1,122 children AML treated two courses standard chemotherapy 2004 2014 in Pediatric Health Information System (PHIS) database, association race (Black versus White) inpatient during was examined. Intensive...
Abstract Background While racial/ethnic survival disparities have been described in pediatric oncology, the impact of income has not extensively explored. We analyzed how public insurance influences 5‐year overall (OS) young patients with sarcomas. Methods The University California San Francisco Cancer Registry was used to identify aged 0‐39 diagnosed bone or soft tissue sarcomas between 2000 and 2015. Low‐income were defined as those no Medicaid, a means‐tested form insurance. Survival...
Abstract Background Transplant‐associated thrombotic microangiopathy (TA‐TMA) is an endothelial injury complication of hematopoietic stem cell transplant (HSCT) leading to end‐organ damage and high morbidity mortality. Defibrotide anti‐inflammatory antithrombotic agent that may protect the endothelium during conditioning. Procedure We hypothesized prophylactic use defibrotide HSCT conditioning acute recovery could prevent TA‐TMA. A pilot single‐arm phase II trial (NCT#03384693) evaluated...
Persons who speak languages other than English are underrepresented in clinical trials, likely part because of inadequate multilevel resources. We conducted a survey institutions affiliated with the Children's Oncology Group (COG) to characterize current research recruitment practices and resources regarding translation interpretation services.
Equal access to clinical trial enrollment is important ensure that findings are generalizable the broader population. This study aimed evaluate disparities in on pediatric oncology trials. We assessed relationship between patient characteristics and COG AAML1031 a cohort of patients with AML Pediatric Health Information System. The associations outcomes were evaluated. Non-Hispanic Black patients, infants, from zip codes lower proportion poverty less likely enroll (30% vs. 61%, p = .004; 34%...
The Children's Oncology Group (COG) Diversity and Health Disparities Committee's (DHDC's) mission is to guarantee the highest standard of care for children adolescents young adults (AYA) with cancer regardless ethnic, racial, gender, or socioeconomic background. We strive identify address issues disparity within existing scientific structure COG support research across improve survival by ensuring equitable access COG-sponsored clinical trials. are committed advance COG-led identifying...
Based on previous reports of disparities in financial burden following a cancer diagnosis, this study aims to characterize mechanisms experienced by caregivers children with cancer, including the impact work flexibility and social support.Cross-sectional survey (in English or Spanish) that assessed household material hardship (HMH), toxicity, income change.Of 156 surveyed, 32% were Hispanic low income. more likely report HMH toxicity compared non-Hispanic White Asian (HMH: 57% vs. 21% 19%, p...
Abstract Background Historical redlining has been associated with inferior survival in adult‐onset cancers. However, its relationship pediatric, adolescent, and young–adult‐onset cancer outcomes is unknown. Methods This study identified incident among individuals <40 years of age living Seattle Tacoma between 2000–2019 via the population‐based Cancer Surveillance System. The authors determined case status using Home Owners’ Loans Corporation data overlaid 2000 2010 census tracts....
Successful allogeneic hematopoietic cell transplantation (HCT) for genetic non-malignant diseases (NMD) is dependent upon elimination of host stem cells (HSCs) and replacement with donor HSCs in stable numbers sufficient to correct the underlying disease. Donor myeloid chimerism (DMC) peripheral blood (PB) a surrogate marker bone marrow HSC engraftment due rapid turnover PB cells. Busulfan commonly used during conditioning patients NMD, though its optimal exposure avoid inadequate DMC not...