SM_282b: Pediatric Cancer Flashcards

1
Q

___ are the leading cause of disease-related death in children

A

Malignant neoplasms are the leading cause of disease-related death in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

___ and ___ are the most common in children

A

Cancers of lymphohematopoietic origin and CNS tumors are the most common in children

  • Tumors of developmental origin are common in younger children
  • Epithelial tumors of lung, breast, prostate, colon RARE in kids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe genetic conditions associated with pediatric cancer

A

Genetic conditions associated with pediatric cancer

  • NF1 and NF2
  • Down syndrome
  • Beckwith-Wiedemann syndrome
  • Tuberous sclerosis
  • von Hippel-Lindau disease
  • Xeroderma pigmentosum
  • Ataxia-telangiectasia
  • Nevus basal cell carcinoma syndrome
  • Li-Fraumeni syndrome (p53)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe viruses associated with childhood cancer

A

Viruses associated with childhood cancer

  • Hodgkin’s lymphoma: EBV
  • Burkitt’s lymphoma: EBV (Africa only)
  • Hepatocellular carcinoma: Hepatitis B and C
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Children with cancer often present with ___

A

Children with cancer often present with vague signs and symptoms

  • Pain is most common presenting symptom of cancer: deeper, visceral structures of organ parenchyma
  • Disseminated disease common
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe common signs and symptoms of pediatric cancer

A

Common signs and symptoms of pediatric cancer

  • Pallor, bruising, persistent fever or infection
  • Pain: persistent or unexplained
  • Headache w/ neurologic deficit
  • Morning headache with vomiting
  • Lymphadenopathy
  • Abdominal pain or mass
  • Extremity swelling
  • Eye changes including proptosis or lack of normal red reflex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe age specific challenges in diagnosis of pediatric cancer

A

Age specific challenges in diagnosis of pediatric cancer

  • infants and young kids have limited ability to express their pain or discomfort
  • Heterogeneity in normal growth and development
  • Adolescents and young adults at risk for delayed diagnosis due to limited interactions with providers and potential loss of health coverage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe general principles of treatment for pediatric cancer

A

General principles of treatment for pediatric cancer

  • Treat at appropriate referral centers
  • Multi-disciplinary care providers
  • Best chance to cure is at first diagnosis
  • Maximize cures while limiting late effects
  • Prioritize outpatient care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe multimodal treatment approach for pediatric cancer

A

Multimodal treatment approach for pediatric cancer

  • Establish accurate diagnosis
  • Initiate treatment rapidly when necessary
  • Chemo is important: more sensitive and tolerate w/ less toxicity
  • Biologic agents becoming more important for up-front therapy
  • Avoid or delay radiation due to serious side effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe lymphohematopoetic malignancies

A

Lymphohematopoetic malignancies

  • Unregulated clonal proliferation of cells in bone marrow (leukemia) or lymph nodes (lymphoma)
  • Growth advantage over normal cells and result in defect in normal function of bone marrow or lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

___ is the most common malignant neoplasm of childhood

A

Acute leukemia is the most common malignant neoplasm of childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

___ accounts for most cases of childhood leukemia

A

ALL accounts for most cases of childhood leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe principles of treatment for pediatric leukemia

A

Principles of treatment for pediatric leukemia

  • Infants have particularly poor prognosis
  • Patients > 10 years and those with adverse molecular features require more aggressive treatment
  • Pace of improvements in cures of acute myeloid leukemia have been slow, with overall survival stagnant between 50-60%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe pediatric lymphomas

A

Pediatric lymphomas

  • Third most common malignancy in kids
  • Broadly distributed between Hodgkin’s and non-Hodgkin’s based upon histologic and molecular features
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

____ are leading cause of cancer-related death in kids

A

CNS tumors are leading cause of cancer-related death in kids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

____ medulloblastoma has good outcomes, while ____ medulloblastoma has poor outcomes

A

Childhood medulloblastoma has good outcomes, while infant medulloblastoma has poor outcomes

17
Q

High grade glioma and DIPG have ___ prognosis

A

High grade glioma and DIPG have poor prognosis

18
Q

Describe neuroblastoma

A

Neuroblastoma

  • Embryonal cancer of PNS that commonly affects younger kids
  • Most common extra-CNS solid tumor in kids
  • Heterogeneous presentation and course: ranges from tumors that undergo spontaneous regression to very aggressive tumors unresponsive to intense multimodal therapy
  • Most cases are sporadic
  • Patients with low and intermediate risk disease have good outcomes
  • High risk disase has poor outcomes and requires aggressive multimodal treatment
19
Q

Describe Wilms tumor (nephroblastoma)

A

Wilms tumor (nephroblastoma)

  • Second most common extra-cranial solid tumor
  • Large
  • Good outcomes after surgery, chemo, and radiation
  • Model disease for improvements in survival through cooperative group efforts
  • Associated with Beckwith-Weideman syndrome
20
Q

Describe pediatric hepatoblastoma

A

Pediatric hepatoblastoma

  • Rare developmental tumor of liver
  • Treatment includes chemo, resection, and occasional liver transplantation
  • Prematurity is known risk factor particularly when umbilical vein catheterization
  • Associated with Beckwith-Weidemann syndrome, hemihypertrophy, and APC gene mutations
21
Q

Describe pediatric sarcomas

A

Pediatric sarcomas

  • Occur at any age across pediatric spectrum
  • Primarily disease of adolescents and young adults
  • Can arise in any anatomic site
  • Outcomes vary
22
Q

____ is the most common pediatric soft tissue sarcoma

A

Rhabdomyosarcoma is the most common pediatric soft tissue sarcoma

  • Neck, GU tract, extremities
23
Q

Describe pediatric osteosarcoma

A

Pediatric osteosarcoma

  • Highest risk during adolescent growth spurt, suggesting relationship between rapid bone growth and malignant transformation
  • Diagnosis confirmed by biopsy and patients require surgeyr and chemo to achieve cure
  • Surgery results in prostheses
24
Q

____ is a ____ common in kids characterized by t(11;22)

A

Ewing’s sarcoma is an undifferentiated sarcoma of bone often with a prominent soft-tissue component common in kids characterized by t(11;22)

25
Q

Ewing’s sarcoma is characterized by ___

A

Ewing’s sarcoma is characterized by t(11;22)

26
Q

Describe retinoblastoma

A

Retinoblastoma

  • Loss of function of RB1 gene via mutation or deletion
  • Hereditary cases diagnosed at younger age and are multifocal and bilateral
  • Sporadic cases usually diagnosed in older ki]ds w/ unilateral and unifocal involvement
  • High survival rate in developed but not elsewhere
  • Associated loss of vision and side effects of therapy
27
Q

___ are a model for improving outcomes for pediatric cancer

A

Cooperative group clinical trials are a model for improving outcomes for pediatric cancer

  • Research consortium
  • Challenges in pediatric cancer research: lack of funding, difficulty motivating pharma companies, rare tumor with limited tumor specimens and patients, long latency between therapeutic concepts and implementation