Lilibeth Torno

• Children's Hospital of Orange County

INTRODUCTION Advances in the treatment of children and adolescents with cancer have resulted in an increased percentage of pediatric cancer survivors (PCSs). However, PCSs are at increased risk of bone health issues from prolonged therapy with corticosteroids, higher cumulative corticosteroid dose, hematopoietic stem cell transplant (HCT), total bo...

Purpose of the review Symptom burden of cancer diagnosis and treatment has led adolescents and young adult cancer patients (AYAC) and survivors to seek different self-management strategies including integrative oncology (IO) modalities. IO holds great promise to improve survivorship issues in adolescents and young adult (AYA) cancer survivors. This...

Access to and understanding one's medical history is crucial to maintaining long-term care. As adolescents and young adults childhood cancer survivors age, they must transition and transfer their health care from their pediatric to an adult care institution. In this study, we provide empirical evidence reporting on the after-cancer treatment experi...

Background Neuropsychiatric symptoms, comprising cognitive impairment, fatigue, insomnia, depression, and anxiety, are prevalent and may co-occur during and after chemotherapy treatment for cancer. Electroacupuncture (EA), which involves mild electrical stimulation with acupuncture, holds great potential in addressing the management of individual s...

Introduction: An adolescent and young adult cancer (AYAC) patient is an individual who has received a cancer diagnosis between 15 and 39 years of age. They require significant survivorship care due to a combination of practical, physical, and mental health problems, but research in these areas is sparse. This study aimed to identify the unmet needs...

Purpose: To describe the process of developing, and evaluating the feasibility and acceptability of, an EMR-based transition readiness assessment. Design and methods: A Cerner-based version of the UNC TRxANSITION Index was implemented across four pediatric subspecialty clinics: epilepsy, inflammatory bowel disease; type 1 diabetes, oncology surv...

Purpose: Oncofertility care for pediatric, adolescent, and young adult cancer patients remains under-implemented across adult and pediatric oncology settings. We pilot tested an electronic health record (EHR)-enabled multicomponent oncofertility intervention (including screening, referral, and fertility consult) in an adult academic oncology progra...

Purpose Research has shown that parents of children with cancer exhibit an altered immune profile compared to parents of healthy children, reflective of increased susceptibility to illness. These parents are also at risk for poorer psychosocial outcomes and quality of life. The current study compares peripheral blood cell analyses and psychosocial...

Purpose Oncofertility care for pediatric, adolescent, and young adult cancer patients remains under-implemented across adult and pediatric oncology settings. We pilot tested an electronic health record (EHR)-enabled multi-component oncofertility intervention (including screening, referral, and fertility consult) in an adult academic oncology progra...

Introduction Given their risk for late effects and early mortality, childhood/adolescent cancer survivors (CACSs) should receive longitudinal monitoring and care. The Southern California Pediatric and Adolescent Cancer Survivorship (SC-PACS) consortium was established in February 2017 to combine resources and expertise across seven participating su...

Endocrine disorders in survivors of childhood, adolescent, and young adult (CAYA) cancers are associated with substantial adverse physical and psychosocial effects. To improve appropriate and timely endocrine screening and referral to a specialist, the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) aims to devel...

Background: Computer-based cognitive rehabilitation programs may help adolescent and young adult (AYA) patients with cancer-related cognitive impairment. This pilot study investigated the feasibility of cognitive rehabilitation as a preventive intervention for AYA patients receiving chemotherapy. Explorative objectives included the correlation of c...

Background: Pediatric oncology patients have high rates of hospital readmission but there is a dearth of research into risk factors for unplanned 30-day readmissions among this high-risk population. Aim: In this study, we built a statistical model to provide insight into risk factors of unplanned readmissions in this pediatric oncology. Methods...

Background: Crizotinib is a first-generation tyrosine kinase inhibitor used for anaplastic lymphoma kinase (ALK) positive cancers. Simple and complex renal cyst formation is a rare complication of crizotinib use that has been reported previously in the adult population. Case: We report a case of a right renal mass in a 17-year-old with ALK-posit...

Objectives Cancer‐related pain in children is prevalent and undermanaged. Mobile health (mHealth) applications provide a promising avenue to address the gap in pain management in children with cancer. Pain Buddy is a multicomponent mHealth application developed to manage cancer‐related pain in children. The goal of this paper is to present prelimin...

Background: Pediatric brain tumor (PBT) survivors and their families are at risk for diminished psychosocial and quality of life outcomes. Community-based programs that leverage peer support in the context of integrative modalities such as traditional Chinese medicine (TCM) represent a promising avenue for meeting the multidimensional needs of surv...

Abstract Background When a child undergoes hematopoietic cell transplantation (HCT), the impact extends to the entire family, including siblings. Assessment of the quality of life (QoL) of siblings is challenged by their general lack of availability for regular assessment by clinical providers. Thus, the use of parent proxy reporting may be useful....

Importance Pediatric cancers are epigenetic diseases; therefore, considering tumor gene expression information is necessary for a complete understanding of the tumorigenic processes. Objective To evaluate the feasibility and utility of incorporating comparative gene expression information into the precision medicine framework for difficult-to-trea...

Once unimaginable, fertility management is now a nationally established part of cancer care in institutions, from academic centers to community hospitals to private practices. Over the last two decades, advances in medicine and reproductive science have made it possible for men, women and children to be connected with an oncofertility specialist or...

The clinical benefits of the MammaPrint® signature for breast cancer is well documented; however, how these genes are related to cell cycle perturbation have not been well determined. Our single-cell transcriptome mapping (algorithm) provides details into the fine perturbation of all individual genes during a cell cycle, providing a view of the cel...

We aimed to describe the quality of life (QOL) among parents of adolescent and young adult brain tumor survivors as well as parent, survivor, and diagnosis/treatment-related factors associated with adverse QOL. A cross-sectional study of 28 parents of adolescent and young adult brain tumor survivors (who were on average 10 y postdiagnosis) was used...

Psychosocial sequelae of diagnosis and treatment for childhood brain tumor survivors are significant, yet little is known about their impact on adolescent and young adult (AYA) brain tumor survivors. Interviews were conducted with parents of AYA brain tumor survivors with a focus on social functioning. Semistructured interviews were conducted with...

Objective: The aim of this study was to examine the associations between age and ethnicity on the development of substance use behaviors among Hispanic and non-Hispanic White (NHW) adolescent and young adult (AYA) childhood cancer survivors. Methods: Participants were recruited from a single institution through the CHOC Children's Hospital Cance...

Glassy cell carcinoma of the cervix (GCCC) is a very rare and aggressive form of cervical cancer. An adolescent female with advanced metastatic disease was enrolled in our genomic profiling research protocol. We identified high-level amplification of epidermal growth factor receptor (EGFR) and Yes-associated protein-1 (YAP1), which led to the addit...

This authoritative reference examines in depth the myriad challenges facing pediatric cancer survivors and proposes a robust framework for structured follow-up of these patients through adulthood. Approaches to long-term follow-up include both established models of care and targeted models of lifelong surveillance of late effects by bodily systems...

Purpose: Focal nodular hyperplasia (FNH), a benign hepatic tumor with ill-defined etiology, has been increasingly reported in children treated for extra-hepatic malignancies. Serial imaging or biopsy may be needed when survivors present with liver lesions. This study aims to review the literature, compare them with our institution’s cohort and prop...

As emphasized in various chapters in this manuscript, childhood cancer survivors often have difficulty with the transition from an integrated and supportive child-oriented care model to adult medical care. While there are various programs at institutions across the country and abroad, CHOC Children’s Hospital has compiled a curriculum designed to g...

The care of childhood cancer survivors has become increasingly more challenging for primary care providers due to the complexity of the treatment received and the recommended risk-based surveillance. This chapter provides roadmaps of suggested studies and laboratory tests derived form the Children’s Oncology Group Long Term Survivor Guidelines. The...

Background: Focal nodular hyperplasia (FNH) is a benign tumor-like structure found in the liver with ill-defined etiology. In asymptomatic patients, serial imaging may be required to monitor for progression. Further confirmation of diagnosis is needed when patients with previous malignancies present with hepatic lesions. An increased incidence of F...

Over 400 cases of pediatric SAA occur annually in the United States. A growing number of children with SAA may have had their stem cells harvested through cord blood collection. We describe a nine-yr-old male with SAA treated successfully with an autologous cord blood transplant following immunoablative chemotherapy. With the increasing number of p...

Conclusion: We observed an extremely low RSV pneumonia fatality rate in contrast to that reported in the literature. Perhaps due to strict control of nosocomial transmission, our cohort tended to contract RSV late, which might account for better outcomes. Our low incidence of NIPCs is intriguing, and could be biased by the fact that 66% of our coho...

The sequential administration of fludarabine followed by cytosine arabinoside (ara-C) has demonstrated significant synergistic effects against the CEM human leukemic cell line. This in vitro synergism was investigated in a Phase I trial in pediatric patients with relapsed acute leukemia. The optimum concentrations of 9-beta-D-arabinofuranosyl 2-flu...

Selective combinations of purine and pyrimidine analogs increase remission rates in pediatric patients with relapsed leukemias. The combination of 6-mercaptopurine (6-MP) and cytosine arabinoside (ara-C) may exhibit synergism similar to that observed for fludarabine and ara-C and may diminish the potential for development of resistance since the tw...