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High‐risk surgically resected pediatric melanoma and adjuvant interferon therapy
Author(s) -
Chao Mwe Mwe,
Schwartz Jennifer L.,
Wechsler Daniel S.,
Thornburg Courtney D.,
Griffith Kent A.,
Williams James A.
Publication year - 2005
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20168
Subject(s) - medicine , melanoma , adjuvant therapy , neutropenia , surgery , biopsy , malignancy , chemotherapy , cancer research
Background Pediatric patients with high‐risk surgically resected melanoma are at risk for relapse, yet little is known about these young patients and how they tolerate high‐dose interferon therapy. Procedure We reviewed medical records of patients (≤18 years) with high‐risk melanoma referred to the University of Michigan Pediatric Hematology‐Oncology service between January 1989 and July 2003. Results Fourteen patients were identified with high‐risk resected melanoma. The median age at diagnosis was 8.5 years. The median time to establish diagnosis was 9 months. Primary lesions were diagnosed as unequivocal melanoma, atypical epithelioid melanocytic proliferations, or atypical Spitz tumor with indeterminate malignant potential. Twelve patients had a positive sentinel lymph node (SLN) biopsy or a palpable regional lymph node and underwent regional lymph node dissection (LND). Two patients with unequivocal melanoma with Breslow depth >4 mm had negative SLN biopsies. Twelve patients received adjuvant high‐dose interferon. The following toxicities were observed: constitutional symptoms, gastrointestinal symptoms, depression or neuropsychiatric symptoms, myelosuppression, elevated AST or ALT, hypothyroidism, and hypertension. Grade 3 or 4 toxicities were uncommon with exception of neutropenia, resulting in modification of therapy in one patient. All patients are alive and free of disease at follow‐up (median 24.5 months). Conclusions Invasive melanoma can occur in very young children. Despite early signs of malignancy, there is often a delay in diagnosis. Histologically, diagnosis may be difficult because of overlap with Spitz nevi. Pediatric patients tolerated adjuvant high‐dose interferon well and may be less likely than adults to require therapy modification secondary to toxicities. © 2004 Wiley‐Liss, Inc.