M. Brooke Bernhardt
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View article: Optimizing high-dose methotrexate treatment regimens to improve exposure and mitigate toxicity in infant patients with acute lymphoblastic leukemia
Optimizing high-dose methotrexate treatment regimens to improve exposure and mitigate toxicity in infant patients with acute lymphoblastic leukemia Open
Introduction: High-dose methotrexate (HDMTX) is a key component of therapy for high risk acute lymphoblastic leukemia (ALL). Typical dosing regimens infuse 5 g/m2 over 24 hours in pediatric and adolescent young adult (AYA) patients without…
View article: Advancing non-sterile pediatric pharmacotherapy through automated compounding and 3D printing of ondansetron hcl dihydrate dosage forms
Advancing non-sterile pediatric pharmacotherapy through automated compounding and 3D printing of ondansetron hcl dihydrate dosage forms Open
Background Pediatric patients often require individualized medication dosing due to variations in age, weight, and swallowing ability. Commercial ondansetron HCl dihydrate formulations are limited by rigid dosing options, unpleasant taste …
View article: An analysis of diagnostic metabolomic profiles associated with hepatotoxicity during childhood ALL induction therapy
An analysis of diagnostic metabolomic profiles associated with hepatotoxicity during childhood ALL induction therapy Open
Hepatotoxicity is a well-documented complication of induction chemotherapy for acute lymphoblastic leukemia (ALL), but our understanding of its biological mechanisms is limited. We identified 314 patients with ALL (aged 1-19 years) treated…
View article: Retraction Note: New recommendations for reversal of high-dose methotrexate cytotoxicity with folinic acid.
Retraction Note: New recommendations for reversal of high-dose methotrexate cytotoxicity with folinic acid. Open
View article: Nutritional status, body composition and chemotherapy dosing in children and young people with cancer: a systematic review by the SIOP nutrition network
Nutritional status, body composition and chemotherapy dosing in children and young people with cancer: a systematic review by the SIOP nutrition network Open
Malnutrition (undernutrition or overweight/obesity) might significantly impact the pharmacokinetics and pharmacodynamics of antineoplastic drugs in children and adolescents (<21 years). A comprehensive systematic literature search was perf…
View article: Automated 3D Printing-Based Non-Sterile Compounding Technology for Pediatric Corticosteroid Dosage Forms in a Health System Pharmacy Setting
Automated 3D Printing-Based Non-Sterile Compounding Technology for Pediatric Corticosteroid Dosage Forms in a Health System Pharmacy Setting Open
Background: Pharmaceutical compounding remains a predominantly manual process with limited innovation, particularly in non-sterile applications. This study explores the implementation of an automated compounding platform based on 3D printi…
View article: Prediction of methotrexate neurotoxicity using clinical, sociodemographic, and area-based information in children with acute lymphoblastic leukemia
Prediction of methotrexate neurotoxicity using clinical, sociodemographic, and area-based information in children with acute lymphoblastic leukemia Open
Background Methotrexate is a critical component of pediatric acute lymphoblastic leukemia (ALL) therapy that can result in neurotoxicity which has been associated with an increased risk of relapse. We leveraged machine learning to develop …
View article: What Is the Expected Clearance of Methotrexate? A Therapeutic Drug Monitoring Reference Guide for High‐Dose Methotrexate Use in Pediatric Malignancies
What Is the Expected Clearance of Methotrexate? A Therapeutic Drug Monitoring Reference Guide for High‐Dose Methotrexate Use in Pediatric Malignancies Open
High‐dose methotrexate dosage and infusion durations differ across treatment protocols for pediatric leukemia, lymphoma, and osteosarcoma. Supportive care interventions are dependent on a patient's elimination of methotrexate (MTX). Theref…
View article: RETRACTED ARTICLE: New recommendations for reversal of high-dose methotrexate cytotoxicity with folinic acid
RETRACTED ARTICLE: New recommendations for reversal of high-dose methotrexate cytotoxicity with folinic acid Open
View article: Delayed excretion of high‐dose methotrexate in pediatric acute leukemia correlates with laxative and constipation management
Delayed excretion of high‐dose methotrexate in pediatric acute leukemia correlates with laxative and constipation management Open
Background Delayed excretion of high‐dose methotrexate (HD‐MTX) in pediatric acute lymphoblastic leukemia (ALL) can result in significant morbidity. While methotrexate is primarily renally excreted, HD‐MTX may overwhelm renal excretion and…
View article: Optimizing early phase clinical trial washout periods: a report from the Therapeutic Advances in Childhood Leukemia and Lymphoma consortium
Optimizing early phase clinical trial washout periods: a report from the Therapeutic Advances in Childhood Leukemia and Lymphoma consortium Open
Background The National Cancer Institute (NCI) issued a 2021 memorandum adopting the American Society of Clinical Oncology (ASCO) and Friends of Cancer Research (Friends) task force recommendations to broaden clinical study eligibility cri…
View article: Methotrexate Scarcity Among Children’s Oncology Group Institutions: Results of a Multinational Survey
Methotrexate Scarcity Among Children’s Oncology Group Institutions: Results of a Multinational Survey Open
Shortages of curative chemotherapy agents for children and adults with cancer are ubiquitous. These shortages directly result in compromised outcomes, increased medication errors, heightened cost to health systems, and patient deaths. Meth…
View article: Clinical covariates that improve the description of high dose methotrexate pharmacokinetics in a diverse population to inform MTXPK.org
Clinical covariates that improve the description of high dose methotrexate pharmacokinetics in a diverse population to inform MTXPK.org Open
The MTXPK.org webtool was launched in December 2019 and was developed to facilitate model‐informed supportive care and optimal use of glucarpidase following the administration of high‐dose methotrexate (HDMTX). One limitation identified du…
View article: Children's Oncology Group's 2023 blueprint for research: Pharmacy
Children's Oncology Group's 2023 blueprint for research: Pharmacy Open
Children's Oncology Group (COG) pharmacists and pharmacy technicians from more than 200 COG‐member institutions comprise the COG Pharmacy Discipline. Discipline members serve an essential role in the design and execution of COG clinical tr…
View article: Impact of undernutrition on the pharmacokinetics of chemotherapy in children with cancer: A systematic review
Impact of undernutrition on the pharmacokinetics of chemotherapy in children with cancer: A systematic review Open
Objectives This systematic review provides an overview of the effect of undernutrition on the pharmacokinetics of chemotherapy in children with cancer. Methods PubMed, Embase, and Cochrane were searched to identify eligible studies. This s…
View article: Children's Oncology Group AALL1331: Phase III Trial of Blinatumomab in Children, Adolescents, and Young Adults With Low-Risk B-Cell ALL in First Relapse
Children's Oncology Group AALL1331: Phase III Trial of Blinatumomab in Children, Adolescents, and Young Adults With Low-Risk B-Cell ALL in First Relapse Open
PURPOSE Blinatumomab, a bispecific T-cell engager immunotherapy, is efficacious in relapsed/refractory B-cell ALL (B-ALL) and has a favorable toxicity profile. One aim of the Children's Oncology Group AALL1331 study was to compare survival…
View article: Repurposing Atovaquone as a Therapeutic against Acute Myeloid Leukemia (AML): Combination with Conventional Chemotherapy Is Feasible and Well Tolerated
Repurposing Atovaquone as a Therapeutic against Acute Myeloid Leukemia (AML): Combination with Conventional Chemotherapy Is Feasible and Well Tolerated Open
Survival of pediatric AML remains poor despite maximized myelosuppressive therapy. The pneumocystis jiroveci pneumonia (PJP)-treating medication atovaquone (AQ) suppresses oxidative phosphorylation (OXPHOS) and reduces AML burden in patien…
View article: Novel and replicated clinical and genetic risk factors for toxicity from high‐dose methotrexate in pediatric acute lymphoblastic leukemia
Novel and replicated clinical and genetic risk factors for toxicity from high‐dose methotrexate in pediatric acute lymphoblastic leukemia Open
Study Objective Methotrexate (MTX) is a key component of treatment for high‐risk pediatric acute lymphoblastic leukemia (ALL) but may cause acute kidney injury and prolonged hospitalization due to delayed clearance. The purpose of this stu…
View article: Ethnic‐specific predictors of neurotoxicity among patients with pediatric acute lymphoblastic leukemia after high‐dose methotrexate
Ethnic‐specific predictors of neurotoxicity among patients with pediatric acute lymphoblastic leukemia after high‐dose methotrexate Open
Background High‐dose methotrexate (HD‐MTX; 5000 mg/m 2 ) is an important component of curative therapy in many treatment regimens for high‐risk pediatric acute lymphoblastic leukemia (ALL). However, methotrexate therapy can result in dose‐…
View article: Safety analysis of high‐dose methotrexate in pediatric non‐Hodgkin lymphomas
Safety analysis of high‐dose methotrexate in pediatric non‐Hodgkin lymphomas Open
High‐dose methotrexate (HD‐MTX) with rigorous supportive care is essential to the treatment of pediatric non‐Hodgkin lymphomas (NHL). We describe the safety and tolerability of HD‐MTX in patients with NHL treated at our center. In our coho…
View article: Clinical and demographic factors contributing to asparaginase-associated toxicities in children with acute lymphoblastic leukemia
Clinical and demographic factors contributing to asparaginase-associated toxicities in children with acute lymphoblastic leukemia Open
A total of 548 patients (age range: 1-22 years, 60.4% Hispanic, 55.8% male) diagnosed with acute lymphoblastic leukemia were reviewed for pegaspargase-associated hypersensitivity (14.8%), hyperbilirubinemia (9.7%), venous thromboembolism (…
View article: Failure Detection in Medical Image Classification: A Reality Check and Benchmarking Testbed
Failure Detection in Medical Image Classification: A Reality Check and Benchmarking Testbed Open
Failure detection in automated image classification is a critical safeguard for clinical deployment. Detected failure cases can be referred to human assessment, ensuring patient safety in computer-aided clinical decision making. Despite it…
View article: Safety Analysis of High-Dose Methotrexate in Pediatric Non-Hodgkin Lymphomas
Safety Analysis of High-Dose Methotrexate in Pediatric Non-Hodgkin Lymphomas Open
High-dose methotrexate (HD-MTX) with rigorous supportive care is essential to the treatment of pediatric non-Hodgkin lymphomas (NHL). We describe the safety and tolerability of HD-MTX in patients with NHL treated at our center. In our coho…
View article: Potential sources of dataset bias complicate investigation of underdiagnosis by machine learning algorithms
Potential sources of dataset bias complicate investigation of underdiagnosis by machine learning algorithms Open
An increasing number of reports raise concerns about the risk that machine learning algorithms could amplify health disparities due to biases embedded in the training data. Seyyed-Kalantari et al. find that models trained on three chest X-…
View article: Algorithmic encoding of protected characteristics in image-based models for disease detection
Algorithmic encoding of protected characteristics in image-based models for disease detection Open
It has been rightfully emphasized that the use of AI for clinical decision making could amplify health disparities. An algorithm may encode protected characteristics, and then use this information for making predictions due to undesirable …
View article: Algorithmic encoding of protected characteristics in image-based models\n for disease detection
Algorithmic encoding of protected characteristics in image-based models\n for disease detection Open
It has been rightfully emphasized that the use of AI for clinical decision\nmaking could amplify health disparities. An algorithm may encode protected\ncharacteristics, and then use this information for making predictions due to\nundesirab…
View article: Rising drug cost impacts on cost‐effectiveness of 2 chemotherapy regimens for intermediate‐risk rhabdomyosarcoma: A report from the Children's Oncology Group
Rising drug cost impacts on cost‐effectiveness of 2 chemotherapy regimens for intermediate‐risk rhabdomyosarcoma: A report from the Children's Oncology Group Open
Background The Children's Oncology Group clinical trial for intermediate risk rhabdomyosarcoma randomized participants to a combination of vincristine, dactinomycin, and cyclophosphamide (VAC) alone or VAC alternating with vincristine plus…
View article: Comparison of the blood, bone marrow, and cerebrospinal fluid metabolomes in children with b-cell acute lymphoblastic leukemia
Comparison of the blood, bone marrow, and cerebrospinal fluid metabolomes in children with b-cell acute lymphoblastic leukemia Open
Metabolomics may shed light on treatment response in childhood acute lymphoblastic leukemia (ALL), however, most assessments have analyzed bone marrow or cerebrospinal fluid (CSF), which are not collected during all phases of therapy. Bloo…
View article: Comparison of The Blood, Bone Marrow, and Cerebrospinal Fluid Metabolomes In Children with B-Cell Acute Lymphoblastic Leukemia
Comparison of The Blood, Bone Marrow, and Cerebrospinal Fluid Metabolomes In Children with B-Cell Acute Lymphoblastic Leukemia Open
Metabolomics may shed light on treatment response in childhood acute lymphoblastic leukemia (ALL), however, most assessments have analyzed bone marrow or cerebrospinal fluid (CSF), which are not collected during all phases of therapy. Bloo…
View article: International Society of Oncology Pharmacy Practitioners (ISOPP) position statement: Role of the oncology pharmacy team in cancer care
International Society of Oncology Pharmacy Practitioners (ISOPP) position statement: Role of the oncology pharmacy team in cancer care Open
The Oncology Pharmacy Team (OPT), consisting of specialty-trained pharmacists and/or pharmacy technicians, is an integral component of the multidisciplinary healthcare team (MHT) involved with all aspects of cancer patient care. The OPT fo…