Advancements in cancer screening and implementation of targeted treatments have significantly improved survival rates to 85% for pediatric and AYA survivors. Greater than 75% of survivors will live to experience the long-term adverse outcomes of cancer therapies, termed late effects (LE), that disrupt quality of life (QoL). Infertility and poor reproductive outcomes are significant disruptors of QoL in survivorship, affecting 12–88% of survivors who receive at-risk therapies. To mitigate risk, fertility preservation (FP) counseling is recommended as standard of care prior to gonadotoxic therapy. However, disparities in FP counseling, implementation of FP interventions, and screening for gynecologic late effects in survivorship persist. Barriers to care include a lack of provider and patient knowledge of the safety and breadth of current FP options, misconceptions about the duration of time required to implement FP therapies, cost, and health care team bias. Developing strategies to address barriers and implement established guidelines are necessary to ensure equity and improve quality of care across populations.

Pediatric central nervous system (CNS) tumors are the most common solid tumor in children, with the majority being glial in origin. These tumors are classified by the World Health Organization (WHO) as either being low grade (WHO grade 1 and 2) or high grade (WHO grade 3 and 4). Our knowledge of the molecular landscape of pediatric brain tumors has advanced over the last decade, which has led to newer categorizations along with an expansion of therapeutic targets and options. In this review, we will give an overview of common CNS tumors seen in children along with a focus on treatment options and future considerations.

Objective: This study aimed to determine if and to what extent (i) socioeconomic disparities exist in the health‐related quality of life (QOL) of children with cancer or brain tumors and healthy children; and (ii) family functioning and burden mediate the relationship between socioeconomic status and children's QOL.Methods: In this cross‐sectional study, parents of children ages 2–18 with (n = 71) and without (n = 135) cancer or brain tumors completed in‐person interviewer‐assisted surveys assessing sociodemographics (including income and parental education), child QOL (measure: PedsQL), family functioning (measure: Family Adaptability and Cohesion Evaluation Scale IV) and burden (measure: Impact on the Family Scale). For children with cancer, clinical characteristics were captured through medical record abstraction. Multiple linear regression was used to determine the relationship between income and child QOL; the interaction between group status and income was assessed. Staged multivariate regression models were used to assess the role of family factors in this relationship among children with cancer.Results: In multivariate analyses, the effect of income differed by cancer status; lower income was associated with worse QOL in children with cancer but not among healthy children. Among children with cancer, this relationship was significantly attenuated by family burden.Conclusions: Significant socioeconomic disparities exist in the QOL of children with cancer. Family factors partially explain the relationship between low income and poor QOL outcomes among these children. Lower‐income families may have fewer resources to cope with their child's cancer. Increased support, monitoring, and referrals to reduce burden for these families may lead to improved QOL in children with cancer. Copyright © 2012 John Wiley & Sons, Ltd.

To describe an unusual case of necrotizing myositis in a rectus muscle, possibly related to BRAF inhibitor therapy. An 18-year old man with neurodegenerative Langerhans cell histiocytosis (LCH), recently started on the BRAF inhibitor dabrafenib, presented with right eye pain. Magnetic resonance imaging (MRI) orbits revealed a rectus muscle mass concerning for LCH recurrence or malignancy. Dabrafenib was stopped, and incisional biopsy of the mass was performed. The mass was absent on post-operative MRI, so no further treatment was pursued. Histopathologic evaluation was initially concerning for sarcoma, but on further analysis, appeared more consistent with necrotizing myositis. The mass did not recur, nor did the patient develop other signs or symptoms concerning for myositis or malignancy over a 24-month follow-up period. Necrotizing myositis has not been previously described in a rectus muscle or with BRAF inhibitor use, though myalgias and malignancies are established side effects. Necrotizing myositis may masquerade as sarcoma and should be on the differential diagnosis for a new mass in the setting of dabrafenib therapy.

Acute myeloid leukemia (AML) with the high-risk variant inv(3)/t(3;3) or t(3;3)(q21;26.2) is rarely seen in the pediatric and young adult population. It is associated with poor outcomes with ineffective therapeutic options. Here, we present a case of an 18-year-old female with treatment refractory inv(3) AML in whom remission was unable to be obtained. Better treatment options are needed given the increased resistance to traditional therapy this subtype portrays. Here, we review the literature on pediatric and young adult inv(3) AML along with newer therapeutic options.