• Pediatric renal tumours
• Histiocytic disorders in children
• Infectious complications in pediatric oncology
• Chemotherapy-induced hearing loss
• Psycho-social impact of childhood cancer on families
• Steroid-induced osteoporosis in pediatric oncology patients

Langherans cell histiocytosis III
Langerhans cell histiocytosis (LCH) is a rare disease that is characterized by the accumulation and proliferation of abnormal bone marrow-derived Langerhans cells. These cells form infiltrates that may be found in various organs and to different extents. The course of disease is unpredictable, varying from spontaneous regression and resolution to rapid progression and death or repeated recurrence with the risk of permanent consequences.  Multiple organ involvement, which is particularly frequent in young children under 2 years, carries the risk of a poor outcome.  Current studies build on previous experience to further advance treatment regimens.

Predicting risk of infection in Canadian children receiving chemotherapy for AML
Invasive infection is the primary cause of death for approximately 7-10% of children with acute myeloid leukemia (AML). There is great variability in the rate and outcome of infection, even among children receiving identical chemotherapy. Despite the importance of infection, infectious outcomes for children with AML have been poorly described and there is little ability to predict which child with AML will develop life-threatening invasive infection. This study may afford us the ability to predict those at highest risk, as any intervention targeted at decreasing infection will likely be associated with considerable toxicity, adverse outcomes or costs.

Steroid-induced osteoporosis in the pediatric population - Canadian incidence study (STOPP-CIS)
There is a growing list of pediatric osteoporotic conditions associated with chronic disease, and studies suggest that glucocorticoids play a pivotal role in the pathogenesis of osteoporosis secondary to childhood illness.  Despite the disadvantages on skeletal metabolism, these drugs are uniformly a part of Canadian treatment protocols for children with leukaemia and nephritic syndrome.  While a number of studies attest to the devastating effects of glucocorticoids on the bone health of children, there are few that document the natural history of skeletal morbidity in pediatric steroid-induced osteoporosis (SO).

End-of-life incidence and implications of hearing loss in pediatric oncology
A significant number of children receiving potentially ototoxic treatment for their cancer have hearing disability, reducing the quality of life and end-of-life/palliative care. There are no studies available that have looked at this population and their special needs. We wish to look whether the need for communication and intervention for the hearing loss are being met.

Parents of children with cancer - A study of factors related to their physical and psychological well-being
Childhood cancer is a life-threatening disease, its onset often acute, its treatment intensive and demanding and possibly extending for several years.  A diagnosis of childhood cancer with its associated range of short and long-term adverse effects is a source of extreme stress for parents. High levels of parental distress have been found in many studies at diagnosis and during active treatment and remission. However, not all parents of children with cancer show high levels of distress. There is considerable variation within and between studies, and the relationship between childhood cancer (the stressor) and parental physical and psychological well-being is not clear.  This study will contribute to understanding this relationship, and will be an important step towards improving services to families of children with cancer.

Gupta A, Capra M, Papaioannou V, Hall G, Maze R, Dix DB, Weitzman S.  Low Incidence of Ototoxicity with Continuous Infusion of Cisplatin in the Treatment of Pediatric Germ Cell Tumors.  Journal Pediatric Hematology/Oncology 2006;28:91-94.

Leung M, Ho S, Hamilton D, Wu JK, Dix DB, Wadsworth L, Ensom M.  Utility of anti-Xa monitoring in children receiving enoxaparin for therapeutic anticoagulation.  J Pediatr Pharmacol Ther 2005 Jan-Mar;10(1):43-50.

Ho S, Wu JK, Hamilton D, Dix DB, Wadsworth L.  An assessment of published pediatric dosage guidelines for enoxaparin: A retrospective review.  J Pediatr Hematol Oncol 2004 Sep;26(9):561-566.

Zogopoulos G, Teskey L, Sung L, Dix DB, Grant R, Greenberg ML, Weitzman S.  Ewing sarcoma: Favourable results with combined modality therapy and conservative use of radiotherapy. Pediatr Blood Cancer 2004 Jul;43:35-9.

Revel-Vilk S, Sharathkumar A, Massicotte P, Marzinotto V, Daneman A, Dix DB, Chan A.  Natural history of arterial and venous thrombosis in children treated with low molecular weight heparin: a longitudinal study by ultrasound.  J Thromb Haemost 2004 Jan;2(1):42-6.

Oncology fellows
Dr. Geoff Cuvelier
Dr. Lisa Goodyear
Dr. Greg Guilcher
Dr. Ewa Lunaczel-Motyka
Dr. Rod Rassekh
Dr. Amanda Turnbull
Dr. Mark Winstanley
Dr. Rebecca Deyell

Research personnel
Amy Scott, Research assistant
Buffy Clague, Clinical research associate
Mary Joan Beleno-Galvez, Clinical research associate
Nita Takeuchi, Senior clinical research associate
Colleen Fitzgerald, Clinical research manager