This study was reported as a poster at the 2003 ASPHO meeting in Seattle, Washington.
High-risk surgically resected pediatric melanoma and adjuvant interferon therapy†
Article first published online: 1 OCT 2004
Copyright © 2004 Wiley-Liss, Inc.
Pediatric Blood & Cancer
Volume 44, Issue 5, pages 441–448, May 2005
How to Cite
Chao, M. M., Schwartz, J. L., Wechsler, D. S., Thornburg, C. D., Griffith, K. A. and Williams, J. A. (2005), High-risk surgically resected pediatric melanoma and adjuvant interferon therapy. Pediatr. Blood Cancer, 44: 441–448. doi: 10.1002/pbc.20168
- Issue published online: 23 MAR 2005
- Article first published online: 1 OCT 2004
- Manuscript Accepted: 22 JUN 2004
- Manuscript Received: 22 APR 2004
- high-risk melanoma;
- interferon alpha;
- pediatric melanoma
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.
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.
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).
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.