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Clinical outcomes of pediatric patients with autism spectrum disorder and other neurodevelopmental disorders and intracranial germ cell tumors
Author(s) -
Liu Kevin X.,
Sethi Roshan V.,
Pulsifer Margaret B.,
D'Gama Alissa M.,
LaVally Beverly,
Ebb David H.,
Tarbell Nancy J.,
Yock Torunn I.,
MacDonald Shan M.
Publication year - 2021
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.28935
Subject(s) - medicine , cohort , germ cell tumors , oncology , autism spectrum disorder , proportional hazards model , incidence (geometry) , retrospective cohort study , pediatrics , cohort study , autism , psychiatry , chemotherapy , physics , optics
Intracranial germ cell tumors (IGCTs) are rare tumors of the central nervous system with peak incidence around puberty. Given the developmental origins of IGCTs, we investigated the prevalence of neurodevelopmental disorders (NDDs) in patients with IGCTs and characterized outcomes for patients with NDD and IGCTs. Methods A retrospective review of medical records was conducted for 111 patients diagnosed with IGCTs between 1998 and 2018 and evaluated at the Massachusetts General Hospital. Kaplan–Meier method and log‐rank test was used for survival analyses. Cox regression analyses were performed for parameters associated with progression‐free survival (PFS). Results Median age at IGCT diagnosis was 12.8 years (range: 4.3–21.7) and median follow‐up was 6.5 years (range: 0.2–20.5). Eighteen patients were diagnosed with NDDs prior to IGCT diagnosis, including five patients with autism spectrum disorder (ASD). Of the 67 patients with pure germinomas, four (6.0 %) had prior ASD diagnoses. Patients with NDD had significantly inferior PFS in the nongerminomatous germ cell tumor (NGGCT) cohort. On univariate and multivariable analyses, craniospinal irradiation (CSI) was significantly associated with improved PFS in the NGGCT cohort. Conclusions Our study found an ASD prevalence in the pure germinoma cohort more than threefold greater than the national prevalence, suggesting an association between ASD and pure germinomas. Furthermore, patients with NDD and NGGCT had worse PFS, possibly due to fewer patients with NDD receiving CSI. Future prospective studies with larger cohorts are needed to examine associations between NDDs and IGCTs, and further characterize outcomes for patients with NDDs and IGCTs.