Adam Levy

Montefiore Medical Center

Background The impact of the coronavirus 2019 (COVID-19) pandemic on the emotional health of health care workers continues to be an area of active research. However, few studies have focused on those working in pediatrics and its subspecialties, as well as ancillary and non-patient-facing staff. The purpose of this study was to determine the preval...

Background Patients with chiasmatic-hypothalamic low-grade glioma (CHLGG) have frequent MRIs with gadolinium-based contrast agents (GBCA) for disease monitoring. Cumulative gadolinium deposition in the brains of children is a potential concern. The purpose of this study is to evaluate whether MRI with GBCA is necessary for determining radiographic...

Background: Approximately 30% of children with medulloblastoma (MB) experience recurrence, which is usually incurable. This study compared the overall survival (OS) of patients receiving temozolomide (TMZ) and irinotecan with that of patients receiving TMZ, irinotecan, and bevacizumab for recurrent MB/central nervous system (CNS) primitive neuroect...

PURPOSE The COVID-19 pandemic has significantly affected the well-being of healthcare workers to varying degrees. The aim of the current study was to investigate how the pandemic has affected the burnout, stress, and emotional well-being of pediatric hematology oncology (PHO) providers and staff in the New York and New Jersey epicenter. METHODS Th...

PurposeCerebral edema from brain tumors can cause neurological impairment. Steroids treat edema but with possible adverse effects. We surveyed providers regarding steroid use in newly diagnosed patients with brain tumors to determine if practices are standard or markedly variable.Methods An anonymous voluntary online survey was sent to members of n...

Objective: The main objective of this study was to determine if family history of malignant peripheral nerve sheath tumor (MPNST) increases risk of developing an MPNST in patients with neurofibromatosis-1 (NF-1). Materials and methods: Individuals with NF-1 registered with the Children's Tumor Foundation's Neurofibromatosis Registry were emailed...

BACKGROUND Despite aggressive therapy including surgery and chemotherapy with or without radiation, approximately 30 percent of children with medulloblastoma (MB) experience recurrence which is usually incurable. The purpose of this study was to compare the overall survival (OS) of patients receiving the combination of temozolomide (TMZ) and irinot...

Communication skills are a competency highlighted by the Accreditation Council on Graduate Medical Education; yet, little is known about the frequency with which trainees receive formal training or what programs are willing to invest. We sought to answer this question and designed a program to address identified barriers. We surveyed pediatric fell...

Background Central nervous system (CNS) germ cell tumors account for 3 % of all pediatric brain tumors in the USA. Presenting symptoms are typically location based with pineal tumors presenting with obstructive hydrocephalus and suprasellar tumors with hypothalamic/pituitary dysfunction and ophthalmologic abnormalities. Psychiatric manifestations s...

Objective: To describe clinicopathological correlation of congenital intracranial immature teratoma. Methods: A retrospective case analysis from a tertiary medical center. Results: We report a case of an intracranial immature teratoma detected prenatally at 35 weeks of gestation. The tumor showed rapid growth, causing acute hydrocephalus requi...

The utilization of next generation sequencing for the identification of actionable gene mutations to guide the choice of therapy towards compounds that selectively inhibit specific genomic alterations is increasingly successful in adult oncology. Yet, limited progress has been achieved in pediatric oncology. Certain pediatric tumor types have shown...

The screening and detection of recurrent medulloblastoma presents the clinician with significant diagnostic challenges, including the risk of misdiagnosis. The authors present the case of a young girl with a history of a treated standard-risk medulloblastoma that highlights the risk of assuming recurrence has occurred when clinical and/or imaging c...

A formal Mentorship Program within the Children's Oncology Group (COG) was established to pair young investigators (mentees) with established COG members (mentors). Despite the American Academy of Pediatrics policy statement promoting mentorship programs, there are no publications describing and evaluating national mentorship programs in pediatric...

There is little data on the amount of time patients and families typically wait for pathology results when pediatric malignancy is suspected. The purpose of this study was to determine the average waiting period after diagnostic intervention for pediatric cancer. Pathology reports were reviewed for pediatric patients who had their initial diagnosis...

Purpose: The discussion that occurs between a pediatric oncologist and a family when they first learn about their child's new diagnosis of cancer is known as the "Day One Talk." Few studies have addressed parent preferences when learning that their child has been diagnosed with cancer. The objective of this study is to assess what information pare...

Febrile neutropenia is a common reason for the hospitalization of pediatric oncology patients. The initiation of antibiotics and the overall decline in rates of bacteremia, would predict a low yield of detection of bacteremia in repeated blood cultures. Despite little evidence supporting the utility of serial cultures, repeat culturing with fever p...

Purpose: To evaluate the effects on 1-year event-free survival (EFS) and overall survival (OS) of combining motexafin and gadolinium (MGd), a potent radiosensitizer, with daily fractionated radiation therapy in children with newly diagnosed intrinsic pontine gliomas. Methods and materials: Patients with newly diagnosed intrinsic pontine glioma w...

Burnout is a work-related syndrome consisting of emotional exhaustion, depersonalization, and diminished feelings of personal accomplishment. Physicians who care for patients with life-threatening illnesses are at high risk for developing burnout. This survey evaluates the prevalence of burnout among pediatric oncologists, and assesses risk factors...

Osteosarcoma does not respond well to conventional dose methotrexate but does respond to high-dose methotrexate. Previous work has indicated that this resistance may be due to impaired transport of methotrexate across the cell membrane. In this study, the PT430 competitive displacement assay was adapted to evaluate methotrexate transport in 69 high...

We describe the safety, feasibility, and provide a cost-estimate of outpatient high-dose methotrexate administration (HDMTX) among an urban, underserved population. A retrospective analysis of ambulatory HDMTX administration among osteosarcoma patients, at Montefiore Medical Center's Children's Hospital (Bronx, NY) was performed. HDMTX (12 g/m(2))...

Investigates whether information specialists, particulalry business information professionals, need additional qualifications, such as an MBA, and recounts the author’s experience of choosing the MBA as being the most appropriate qualification for expanding her earlier skills, which were technically focused. Notes the strategy used to choose which...

A formal Mentorship Program within the Children's Oncology Group (COG) was established to pair young investigators (mentees) with established COG members (mentors). Despite the American Academy of Pediatrics policy statement promoting mentorship programs, there are no publications describing and evaluating national mentorship programs in pediatric...

Antiepileptic drugs are frequently used in children with brain tumors. This retrospective study reviewed chronic use of antiepileptic drugs in children with brain tumors at two children's hospitals between 2000 and 2007. Antiepileptic drugs were used in 32/334 pediatric brain tumor patients (10%). Almost all (94%) had supratentorial tumors, of whic...

Preclinical testing suggests the combination of carboplatin and irinotecan has at least additive antitumor activity. The primary objectives of the current study were to determine the maximum tolerated doses (MTDs) and recommended phase 2 doses of carboplatin administered with irinotecan to pediatric patients with refractory solid tumors. This was a...

Fine-needle aspiration biopsy (FNAB) is a well-recognized minimally invasive tool in the diagnosis of neoplasia of various organ systems. Several reports in the literature suggest that FNAB can be an accurate method for the preoperative diagnosis and treatment planning. We describe a case to caution the interpretation from a FNAB that contains subo...

Atypical teratoid rhabdoid tumors (ATRT) are highly malignant tumors of the central nervous system with a peak incidence in children less than 3 years of age. Despite multimodal therapy including surgery, radiation and chemotherapy, the prognosis remains dismal. No specific treatment guidelines are defined for ATRTs but a gross total resection and...

The purpose of this study is to investigate the efficacy of an intensive chemotherapy induction regimen followed by myeloablative chemotherapy and autologous hematopoietic stem cell rescue (AHSCR) in children with newly diagnosed ependymoma. Twenty-nine children less than 10 years of age at diagnosis of ependymoma were enrolled on the "Head Start"...

Brain and spinal cord tumors represent the most common solid tumors in children. Recent advances in imaging techniques, neurosurgical techniques, chemotherapy approaches, and radiation oncology have resulted in some improvement in overall survival and morbidity. However, the prognosis for many children with high-grade and malignant brain tumors rem...

To evaluate the feasibility of and response rate to an intensified induction chemotherapy regimen for young children with newly diagnosed high-risk or disseminated medulloblastomas. From January 1997 to March 2003, 21 patients with high-risk or disseminated medulloblastoma were enrolled. After maximal surgical resection, patients were treated with...

Methotrexate is a major component of current treatment regimens for children with acute lymphocytic leukemia (ALL). Potential mechanisms of methotrexate resistance include impaired drug uptake, decreased drug retention, and dihydrofolate reductase (DHFR) amplification. The purpose of this study was to assess whether reduced folate carrier (RFC) and...

Studies have suggested that high P-glycoprotein expression in lymphocytes from patients with autoimmune disorders may affect disease outcome. Idiopathic thrombocytopenic purpura (ITP) and Evans' syndrome are widely thought to be autoimmune processes, however, the precise mechanisms remain unknown. Peripheral blood mononuclear cells from patients wi...

Patients with Ewing’s sarcoma should be transferred to a comprehensive cancer center for evaluation and management when the diagnosis is suspected. Proper biopsy technique is essential to preserve all therapeutic options, including limb preservation surgery. In addition to conventional histologic examination, biopsy tissue must be obtained for mole...