Utility of automated counting to determine absolute neutrophil counts and absolute phagocyte counts for pediatric cancer treatment protocols

Cancer ◽  
2004 ◽  
Vol 101 (11) ◽  
pp. 2681-2686 ◽  
Author(s):  
Nobuko Hijiya ◽  
Mihaela Onciu ◽  
Scott C. Howard ◽  
Zhe Zhang ◽  
Cheng Cheng ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Pediatric Cancer ◽  
Treatment Protocols ◽  
Cancer Treatment Protocols

Classifying the intensity of pediatric cancer treatment protocols: The intensity of treatment rating scale 2.0 (ITR-2)

2007 ◽  
Vol 48 (7) ◽  
pp. 673-677 ◽  
Author(s):  
Branlyn E. Werba ◽  
Wendy Hobbie ◽  
Anne E. Kazak ◽  
Richard F. Ittenbach ◽  
Anne F. Reilly ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Pediatric Cancer ◽  
Rating Scale ◽  
Treatment Protocols ◽  
Cancer Treatment Protocols ◽  
Intensity Of Treatment

scholarly journals Development of mNavigator: Digital Health Application to Facilitate Compliance With Standardized Pediatric Cancer Treatment Protocols in Tanzania

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 44-44
Author(s):  
Kristin Schroeder ◽  
Yadurshini Raveendran ◽  
Kunal Goel ◽  
Christina Makarushka ◽  
Mwitasrobert Gisiri ◽  
...  
Keyword(s):  
Case Management ◽  
Cancer Treatment ◽  
Pediatric Cancer ◽  
Digital Health ◽  
Survival Rates ◽  
Health Provider ◽  
Treatment Protocols ◽  
Middle Income ◽  
Standardized Treatment ◽  
Cancer Treatment Protocols

PURPOSE Use of standardized treatment protocols has been demonstrated to improve outcomes for pediatric patients with cancer. Yet it is challenging to implement standardized treatment protocols in low- and middle-income countries as a result of infrastructure and resource constraints, as well as poor health provider compliance with treatment protocols. At Bugando Medical Centre (BMC) in Tanzania, health provider compliance with standardized paper-based treatment protocols is low at 22%. One-year overall survival rates among pediatric patients with cancer at BMC are 40% and almost one third of patients abandon treatment. We posit that improving protocol compliance in this setting may decrease treatment abandonment and improve survival rates. Use of digital case management systems has been shown to improve compliance with treatment protocols because of the ability to incorporate such features as decision-support algorithms, prompts and alerts, and checklists. The digital health application mNavigator was designed to facilitate health provider compliance with standardized pediatric cancer treatment protocols in Tanzania. METHODS mNavigator was developed by adapting an open-source digital case management platform called CommCare. The three stages of mNavigator development were as follows: workflow mapping and form development; form programming in CommCare; and quality assurance using mock and deidentified patient records to identify errors in information flow or outputs, assess preliminary usability, and determine areas for improvement. Standardized treatment protocols for Burkitt lymphoma and retinoblastoma were initially incorporated into mNavigator. The mNavigator prototype underwent usability testing at BMC before implementation in routine clinical practice. RESULTS Preliminary system usability, acceptance, and satisfaction evaluation demonstrated high usability response scores (> 80%). Perceived benefits of the mNavigator system included a user-friendly interface, improved record keeping, and assistance with patient tracking using standardized treatment protocols. Suggestions for improvement centered on the incorporation of other standardized treatment protocols (eg, Wilms tumor), improving interoperability with existing electronic recordkeeping systems, and making similar systems available for other clinical departments. CONCLUSION To our knowledge, mNavigator is the first digital health case management system specifically developed to improve health provider compliance with pediatric cancer treatment protocols in a low-resource setting. With high usability and acceptability, mNavigator has been implemented in routine clinical practice. Implementation and patient outcomes evaluations are ongoing and will inform the scale-up for use in other low- and middle-income countries.

scholarly journals A case of pembrolizumab-induced severe DKA and hypothyroidism in a patient with metastatic melanoma

2019 ◽  
Vol 2019 ◽  
Author(s):  
Osamah A Hakami ◽  
Julia Ioana ◽  
Shahzad Ahmad ◽  
Tommy Kyaw Tun ◽  
Seamus Sreenan ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Cancer Treatment ◽  
Metastatic Melanoma ◽  
Checkpoint Inhibitors ◽  
Advanced Melanoma ◽  
Blood Glucose Monitoring ◽  
Thyroid Peroxidase ◽  
List Type ◽  
Treatment Protocols ◽  
Cancer Treatment Protocols

Summary Immune checkpoint inhibitors (ICIs) have revolutionised cancer therapy and improved outcomes for patients with advanced disease. Pembrolizumab, a monoclonal antibody that acts as a programmed cell death 1 (PD-1(PDCD1)) inhibitor, has been approved for the treatment of advanced melanoma and other solid tumours. Immune-related adverse events (irAEs) including endocrinopathies have been well described with this and other PD-1 inhibitors. While hypothyroidism and hyperthyroidism, and less commonly hypophysitis, are the most common endocrinopathies occurring in patients treated with pembrolizumab, the incidence of type 1 diabetes mellitus (T1DM) was low in clinical trials. We report a case of pembrolizumab-induced primary hypothyroidism and T1DM presenting with severe diabetic ketoacidosis (DKA). A 52-year-old male patient was treated with pembrolizumab for metastatic melanoma. He presented to the emergency department with a 1-day history of nausea and vomiting 2 weeks after his seventh dose of pembrolizumab, having complained of polyuria and polydipsia for 2 months before presentation. He had been diagnosed with thyroid peroxidase (TPO) antibody-negative hypothyroidism, requiring thyroxine replacement, shortly after his fifth dose. Testing revealed a severe DKA (pH: 6.99, glucose: 38.6 mmol/L, capillary ketones: 4.9 and anion gap: 34.7). He was treated in the intensive care unit as per the institutional protocol, and subsequently transitioned to subcutaneous basal-bolus insulin. After his diabetes and thyroid stabilised, pembrolizumab was recommenced to treat his advanced melanoma given his excellent response. This case highlights the importance of blood glucose monitoring as an integral part of cancer treatment protocols composed of pembrolizumab and other ICIs. Learning points: The incidence of T1DM with pembrolizumab treatment is being increasingly recognised and reported, and DKA is a common initial presentation. Physicians should counsel patients about this potential irAE and educate them about the symptoms of hyperglycaemia and DKA. The ESMO guidelines recommend regular monitoring of blood glucose in patients treated with ICIs, a recommendation needs to be incorporated into cancer treatment protocols for pembrolizumab and other ICIs in order to detect hyperglycaemia early and prevent DKA.

scholarly journals Male Breast Cancer: Reevaluate Our Opinion

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Santosh Kale ◽  
Rajmohan Rammohan ◽  
Vilma Vas ◽  
Chris Elsayad
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Hormonal Therapy ◽  
Female Breast Cancer ◽  
Breast Cancer Treatment ◽  
Male Breast ◽  
Breast Cancers ◽  
Treatment Protocols ◽  
Female Breast ◽  
Cancer Treatment Protocols

Male breast cancers (MBCs) are relatively uncommon malignancy with less than 1% incidence. MBC presents at a later age with a more advanced presentation as compared to the female breast cancer. Due to the paucity of the number of cases and trials regarding the MBC, female breast cancer treatment protocols are applied. Mastectomy and hormonal therapy remains the mainstay of treatment. Moreover, the data about prognosis of MBC remains limited.

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