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Hearing Disorders: HELP
Articles by Johnnie K. Bass
Based on 15 articles published since 2010
(Why 15 articles?)
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Between 2010 and 2020, J. Bass wrote the following 15 articles about Hearing Disorders.
 
+ Citations + Abstracts
1 Editorial New International Society of Pediatric Oncology Boston Ototoxicity Grading Scale for pediatric oncology: still room for improvement. 2012

Gurney, James G / Bass, Johnnie K. · ·J Clin Oncol · Pubmed #22547588.

ABSTRACT: -- No abstract --

2 Review Evaluation and Management of Hearing Loss in Survivors of Childhood and Adolescent Cancers: A Report From the Children's Oncology Group. 2016

Bass, Johnnie K / Knight, Kristin R / Yock, Torunn I / Chang, Kay W / Cipkala, Douglas / Grewal, Satkiran S. ·Rehabiliation Services, St Jude Children's Research Hospital, Memphis, Tennessee. · Child Development and Rehabilitation Center, Oregon Health and Science University, Portland, Oregon. · Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts. · Department of Otolaryngology, Stanford University, Stanford, California. · Center for Cancer and Blood Diseases, Peyton Manning Children's Hospital at St. Vincent, Indianapolis, Indiana. · Pediatric Hematology-Oncology, Baystate Medical Center, Springfield, Massachusetts. ·Pediatr Blood Cancer · Pubmed #26928933.

ABSTRACT: Hearing loss (HL) is common in childhood cancer survivors exposed to platinum chemotherapy and/or cranial radiation and can severely impact quality of life. Early detection and appropriate management can mitigate academic, speech, language, social, and psychological morbidity resulting from hearing deficits. This review is targeted as a resource for providers involved in aftercare of childhood cancers. The goal is to promote early identification of survivors at-risk for HL, appropriate evaluation and interpretation of diagnostic tests, timely referral to an audiologist when indicated, and to increase knowledge of current therapeutic options.

3 Clinical Trial Auditory Outcomes in Patients Who Received Proton Radiotherapy for Craniopharyngioma. 2018

Bass, Johnnie K / Huang, Jie / Hua, Chia-Ho / Bhagat, Shaum P / Mendel, Lisa Lucks / Onar-Thomas, Arzu / Indelicato, Daniel J / Merchant, Thomas E. ·Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN. · Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN. · Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN. · Department of Communication Disorders and Sciences, San Jose State University, CA. · School of Communication Sciences and Disorders, University of Memphis, TN. · Department of Radiation Oncology, University of Florida, Jacksonville. ·Am J Audiol · Pubmed #30073327.

ABSTRACT: Purpose: Compared to photon-based radiotherapy, protons deliver less radiation to healthy tissue resulting in the potential reduction of late complications such as sensorineural hearing loss (SNHL). We report early auditory outcomes in children treated with proton radiotherapy (PRT) for craniopharyngioma. Method: Conventional frequency (CF = 0.25-8.0 kHz) audiometry, extended high-frequency (EHF = 9.0-16.0 kHz) audiometry, distortion product otoacoustic emission (DPOAE) testing, and speech-in-noise (SIN) assessments were prospectively and longitudinally conducted on 74 children with a median of 2 post-PRT evaluations (range, 1-5) per patient. The median age at PRT initiation was 10 years, and median follow-up time was 2 years. Ototoxicity was classified using the Chang Ototoxicity Grading Scale (Chang & Chinosornvatana, 2010) and the American Speech-Language-Hearing Association (ASHA) criteria (ASHA, 1994). Comparisons were made between baseline and most recent DPOAE levels, with evidence of ototoxicity based on criterion reductions of ≥ 6 dB. The critical difference values for comparing SIN scores between two conditions (i.e., pre- and post-PRT) were used to determine a significant change between test scores. Results: At last evaluation, no patients had SNHL in the CF range, and 2 patients had SNHL (Chang Grade 1a) in the EHF range. Based on the ASHA criteria, a decrease in hearing was observed in 0 patients in the CF range alone, in 9 patients in the EHF range alone, and in 15 patients in both the CF and EHF ranges. DPOAE levels decreased at a faster rate at higher versus lower frequencies. For 41 evaluable patients, SIN perception did not decline over time (p = .6463). Conclusion: At a median follow-up time of 2 years post-PRT, normal hearing was maintained within the CF range. However, subclinical decreases in hearing were observed, particularly in the EHF range and in the DPOAE level; thus, long-term follow-up is recommended to monitor for potential auditory late effects from PRT.

4 Clinical Trial Evaluation of amifostine for protection against cisplatin-induced serious hearing loss in children treated for average-risk or high-risk medulloblastoma. 2014

Gurney, James G / Bass, Johnnie K / Onar-Thomas, Arzu / Huang, Jie / Chintagumpala, Murali / Bouffet, Eric / Hassall, Tim / Gururangan, Sridharan / Heath, John A / Kellie, Stewart / Cohn, Richard / Fisher, Michael J / Panandiker, Atmaram Pai / Merchant, Thomas E / Srinivasan, Ashok / Wetmore, Cynthia / Qaddoumi, Ibrahim / Stewart, Clinton F / Armstrong, Gregory T / Broniscer, Alberto / Gajjar, Amar. ·Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.) · Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.) · Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.) · Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.) · Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.) · Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.) · Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.) · Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.) · Hospital for Sick Children, Toronto, Ontario, Canada (E.B.) · Royal Children's Hospital Brisbane, Herston, Australia (T.H.) · The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.) · The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.) · Children's Hospital at Westmead, Sydney, Australia (S.K.) · Sydney Children's Hospital, Sydney, Australia (R.C.) · Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.) · School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.). ·Neuro Oncol · Pubmed #24414535.

ABSTRACT: BACKGROUND: The purpose of this study was to evaluate amifostine for protection from cisplatin-induced serious hearing loss in patients with average-risk medulloblastoma by extending a previous analysis to a much larger sample size. In addition, this study aimed to assess amifostine with serious hearing loss in patients with high-risk medulloblastoma treated with cisplatin. METHODS: Newly diagnosed medulloblastoma patients (n = 379; ages 3-21 years), enrolled on one of 2 sequential St. Jude clinical protocols that included 4 courses of 75 mg/m(2) cisplatin, were compared for hearing loss by whether or not they received 600 mg/m(2) of amifostine immediately before and 3 hours into each cisplatin infusion. Amifostine administration was not randomized. The last audiological evaluation between 5.5 and 24.5 months following protocol treatment initiation was graded using the Chang Ototoxicity Scale. A grade of ≥ 2b (loss requiring a hearing aid or deafness) was considered a serious event. RESULTS: Among average-risk patients (n = 263), amifostine was associated with protection from serious hearing loss (adjusted OR, 0.30; 95% CI, 0.14-0.64). For high-risk patients (n = 116), however, there was not sufficient evidence to conclude that amifostine prevented serious hearing loss (OR, 0.89; 95% CI, 0.31-2.54). CONCLUSIONS: Although patients in this study were not randomly assigned to amifostine treatment, we found evidence in favor of amifostine administration for protection against cisplatin-induced serious hearing loss in average-risk but not in high-risk, medulloblastoma patients.

5 Clinical Trial Time-frequency analysis of transient-evoked otoacoustic emissions in children exposed to carboplatin chemotherapy. 2013

Bhagat, Shaum / Bass, Johnnie / Qaddoumi, Ibrahim / Brennan, Rachel / Wilson, Matthew / Wu, Jianrong / Galindo, Carlos-Rodriguez / Paglialonga, Alessia / Tognola, Gabriella. ·Hearing Science Laboratory, School of Communication Sciences and Disorders, The University of Memphis, and St. Jude Children's Research Hospital, Memphis, TN 38105, USA. sbhagat@memphis.edu ·Audiol Neurootol · Pubmed #23147804.

ABSTRACT: The aims of this study were to characterize and quantify time-frequency changes in transient-evoked otoacoustic emissions (TEOAEs) recorded in children diagnosed with retinoblastoma who were receiving carboplatin chemotherapy. A signal processing technique, the wavelet transform (WT), was used to analyze TEOAE waveforms in narrow-band frequency components. Ten children (aged 3-72 months) diagnosed with unilateral or bilateral retinoblastoma were enrolled in the study. TEOAEs were acquired from the children with linear sequences of 70 dB peak equivalent SPL clicks. After WT analysis, TEOAE energy, latency and normalized energy in the narrow-band frequency components were compared before and during carboplatin chemotherapy treatment (average dose 1693 mg/m2). On a group basis, no significant differences (p>0.05) in the TEOAE energy, latency or normalized energy before and after carboplatin treatment were observed. There were decreases in normalized energy on an individual basis in 10 out of 18 ears in the sample. Exposure to carboplatin chemotherapy did not cause significant changes in TEOAE energy, latency and normalized energy during treatment. However, long-term monitoring of hearing with measurements of TEOAEs is warranted, given the risks of delayed hearing loss in some children receiving carboplatin chemotherapy.

6 Article Treatment burden and long-term health deficits of patients with low-grade gliomas or glioneuronal tumors diagnosed during the first year of life. 2019

Liu, Anthony P Y / Hastings, Camden / Wu, Shengjie / Bass, Johnnie K / Heitzer, Andrew M / Ashford, Jason / Vestal, Robert / Hoehn, Mary E / Ghazwani, Yahya / Acharya, Sahaja / Conklin, Heather M / Boop, Frederick / Merchant, Thomas E / Gajjar, Amar / Qaddoumi, Ibrahim. ·Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee. · Pediatric Oncology Education Program, St. Jude Children's Research Hospital, Memphis, Tennessee. · Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee. · St. Jude Children's Research Hospital, Rehabilitation Services, Memphis, Tennessee. · Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee. · Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee. · Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee. · Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee. · Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee. · Le Bonheur Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, Tennessee. · Semmes Murphey Clinic, Memphis, Tennessee. ·Cancer · Pubmed #30620400.

ABSTRACT: BACKGROUND: Low-grade gliomas (LGGs) and low-grade glioneuronal tumors (LGGNTs) diagnosed during the first year of life carry unique clinical characteristics and challenges in management. However, data on the treatment burden, outcomes, and morbidities are lacking. METHODS: A retrospective study of LGGs and LGGNTs diagnosed in patients younger than 12 months at St. Jude Children's Research Hospital (1986-2015) was conducted. RESULTS: For the 51 patients (including 31 males), the mean age at diagnosis was 6.47 months (range, 0.17-11.76 months), and the mean follow-up period was 11.8 years (range, 0.21-29.19 years). Tumor locations were hypothalamic/optic pathway (61%), hemispheric (12%), brainstem (12%), cerebellar (8%), and spinal (8%). There were 41 patients with histological diagnoses: 28 had World Health Organization grade 1 tumors, 6 had grade 2 tumors, and 7 had an LGG/LGGNT not definitively graded. Forty-one patients required an active intervention at diagnosis. Throughout their treatment course, 41 patients eventually underwent tumor-directed surgeries (median, 2 surgeries; range, 1-6), 39 received chemotherapy (median, 2 regimens; range, 1-13), and 21 received radiotherapy. Forty patients experienced disease progression (median, 2 progressions; range, 1-18). Ten patients died of progression (n = 5), malignant transformation (n = 2), a second cancer (n = 2), or a shunt infection (n = 1). The 10-year overall survival, progression-free survival, and radiation-free survival rates were 85% ± 5.3%, 16.9% ± 5.3%, and 51.2% ± 7.5%, respectively. Forty-nine patients experienced health deficits (eg, endocrinopathies, obesity, seizures, visual/hearing impairments, neurocognitive impairments, and cerebrovascular disease). Predictors of progression and toxicities were defined. CONCLUSIONS: Infantile LGG/LGGNT is a chronic, progressive disease universally associated with long-term morbidities and requires multidisciplinary intervention.

7 Article Hearing Loss in Patients Who Received Cranial Radiation Therapy for Childhood Cancer. 2016

Bass, Johnnie K / Hua, Chia-Ho / Huang, Jie / Onar-Thomas, Arzu / Ness, Kirsten K / Jones, Skye / White, Stephanie / Bhagat, Shaum P / Chang, Kay W / Merchant, Thomas E. ·Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital · Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN · and Kay W. Chang, Stanford University, Stanford, CA. ·J Clin Oncol · Pubmed #26811531.

ABSTRACT: PURPOSE: Patients treated with cranial radiation therapy (RT) are at risk for sensorineural hearing loss (SNHL). Although SNHL is often characterized as a delayed consequence of anticancer therapy, longitudinal reports of SNHL in childhood cancer survivors treated with contemporary RT are limited. We report the incidence, onset, severity, and long-term trajectory of SNHL among children receiving RT. Potential risk factors for SNHL were also identified. PATIENTS AND METHODS: Serial audiologic testing was conducted on 235 pediatric patients who were treated with conformal or intensity-modulated RT as part of an institutional phase II trial for localized primary brain tumors, including craniopharyngioma, ependymoma, and juvenile pilocytic astrocytoma. All but one patient had measurable cochlear radiation dose (CRD) greater than 0 Gy. The median follow-up from RT initiation to latest audiogram was 9 years with a median of 11 post-RT audiograms per patient. Audiograms were classified by the Chang Ototoxicity Grading Scale. Progression was defined by an increase in Chang grade from SNHL onset to the most recent evaluation. RESULTS: At last evaluation, SNHL was prevalent in 14% of patients: 2.1% had mild and 11.9% had significant SNHL requiring hearing aids. Median time from RT to SNHL onset was 3.6 years (range, 0.4 to 13.2 years). Among 29 patients with follow-up evaluations after SNHL onset, 65.5% experienced continued decline in hearing sensitivity in either ear and 34.5% had no change. Younger age at RT initiation (hazard ratio [HR], 2.32; 95% CI, 1.21 to 4.46), higher CRD (HR, 1.07; 95% CI, 1.03 to 1.11), and cerebrospinal fluid shunting (HR, 2.02; 95% CI, 1.07 to 3.78) were associated with SNHL. CONCLUSION: SNHL is a late effect of RT that likely worsens over time. Long-term audiologic follow-up for a minimum of 10 years post-RT is recommended.

8 Article Treatment-induced hearing loss and adult social outcomes in survivors of childhood CNS and non-CNS solid tumors: Results from the St. Jude Lifetime Cohort Study. 2015

Brinkman, Tara M / Bass, Johnnie K / Li, Zhenghong / Ness, Kirsten K / Gajjar, Amar / Pappo, Alberto S / Armstrong, Gregory T / Merchant, Thomas E / Srivastava, Deo Kumar / Robison, Leslie L / Hudson, Melissa M / Gurney, James G. ·Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee. · Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee. · Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee. · Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee. · Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee. · School of Public Health, University of Memphis, Tennessee. ·Cancer · Pubmed #26287566.

ABSTRACT: BACKGROUND: Survivors of childhood cancer who are treated with platinum-based chemotherapy and/or cranial radiation are at risk of treatment-induced hearing loss. However, the effects of such hearing loss on adult social attainment have not been well elucidated. METHODS: Adult survivors of pediatric central nervous system (CNS) solid tumors (180 survivors) and non-CNS solid tumors (226 survivors) who were treated with potentially ototoxic cancer therapy completed audiologic evaluations and questionnaires assessing their perception of social functioning and social attainment (ie, independent living, marriage, and employment). Audiograms were graded with the Chang ototoxicity grading scale. Analyses were stratified by tumor type (ie, CNS vs non-CNS). Multivariable logistic regression models were conducted with adjustment for age; sex; chronic health conditions; and, for the CNS group, IQ. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were reported. RESULTS: Serious hearing loss (that requiring a hearing aid or deafness) was detected in 36% of survivors of CNS tumors and 39% of survivors of non-CNS tumors. Serious hearing loss was associated with an increased risk of perceived negative impact in ≥1 areas of social functioning (survivors of non-CNS tumors: OR, 1.83 [95% CI, 1.00-3.34]). Among survivors of non-CNS tumors, serious hearing loss was associated with 2-fold increased risk of nonindependent living (OR, 2.19; 95% CI, 1.19-4.04) and unemployment or not graduating from high school (OR, 1.85; 95% CI, 1.00-3.34). CONCLUSIONS: A substantial proportion of adult survivors of childhood cancer treated with potentially ototoxic therapy have serious hearing loss. Treatment-induced hearing loss was found to be associated with reduced social attainment, both perceived and actual, in this study sample.

9 Article Common variants in ACYP2 influence susceptibility to cisplatin-induced hearing loss. 2015

Xu, Heng / Robinson, Giles W / Huang, Jie / Lim, Joshua Yew-Suang / Zhang, Hui / Bass, Johnnie K / Broniscer, Alberto / Chintagumpala, Murali / Bartels, Ute / Gururangan, Sri / Hassall, Tim / Fisher, Michael / Cohn, Richard / Yamashita, Tetsuji / Teitz, Tal / Zuo, Jian / Onar-Thomas, Arzu / Gajjar, Amar / Stewart, Clinton F / Yang, Jun J. ·1] Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. [2] Department of Laboratory Medicine, National Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China. · Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. · Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. · 1] Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. [2] Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. · Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. · Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. · Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas, USA. · Department of Haematology and Oncology, Hospital for Sick Children, Toronto, Ontario, Canada. · Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA. · Department of Oncology, The Royal Children's Hospital, Parkville, Victoria, Australia. · Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. · School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia. · Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. ·Nat Genet · Pubmed #25665007.

ABSTRACT: Taking a genome-wide association study approach, we identified inherited genetic variations in ACYP2 associated with cisplatin-related ototoxicity (rs1872328: P = 3.9 × 10(-8), hazard ratio = 4.5) in 238 children with newly diagnosed brain tumors, with independent replication in 68 similarly treated children. The ACYP2 risk variant strongly predisposed these patients to precipitous hearing loss and was related to ototoxicity severity. These results point to new biology underlying the ototoxic effects of platinum agents.

10 Article Challenges in ototoxicity monitoring in the pediatric oncology population. 2014

Bass, Johnnie K / Bhagat, Shaum P. ·University of Memphis, Hearing Science Laboratory, School of Communication Sciences and Disorders, Memphis, TN; St. Jude Children's Research Hospital, Rehabilitation Services, Memphis, TN. ·J Am Acad Audiol · Pubmed #25380122.

ABSTRACT: BACKGROUND: Platinum-based chemotherapy and cranial radiation are effective treatment options commonly prescribed for a variety of childhood cancers. These therapies can, and often do, result in early- and late-onset adverse health effects such as hearing loss. Undetected hearing loss is particularly concerning in young children developing speech and language skills and can negatively affect academic achievement and the psychosocial well-being of both young and older children. Early detection of hearing loss in pediatric oncology patients and early intervention are critical to help these patients succeed in achieving these developmental milestones. PURPOSE: The primary goal of this study was to create a tutorial for audiologists concerning the monitoring of ototoxicity in the pediatric oncology population. Monitoring hearing for children receiving potentially ototoxic cancer treatments presents special issues and challenges for audiologists. This tutorial will orient the reader to these special issues and challenges, and potential solutions will be proposed. DESIGN: This tutorial is organized into sections, including an overview of platinum compound and cranial radiation treatments commonly used to treat pediatric cancer, modifications of the test battery required to appropriately monitor for ototoxic hearing loss in children, a proposal for a monitoring protocol, and descriptions of the grading scales that are frequently used by oncologists to determine the severity of ototoxic hearing loss. CONCLUSIONS: Identification of ototoxicity is crucial in children receiving cancer treatments because of the impact that acquired hearing loss has on social and educational outcomes in the developing child. Monitoring hearing in children presents challenges that are unique to this population. Much effort has been put forth in developing and validating the International Society of Pediatric Oncology ototoxicity grading scale for international use in reporting auditory outcomes in clinical trials. In the future, the development of standardized monitoring protocols will assist audiologists in providing optimal care to children treated for cancer.

11 Article Concordance between the chang and the International Society of Pediatric Oncology (SIOP) ototoxicity grading scales in patients treated with cisplatin for medulloblastoma. 2014

Bass, Johnnie K / Huang, Jie / Onar-Thomas, Arzu / Chang, Kay W / Bhagat, Shaum P / Chintagumpala, Murali / Bartels, Ute / Gururangan, Sridharan / Hassall, Tim / Heath, John A / McCowage, Geoffrey / Cohn, Richard J / Fisher, Michael J / Robinson, Giles / Broniscer, Alberto / Gajjar, Amar / Gurney, James G. ·Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee; School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee. ·Pediatr Blood Cancer · Pubmed #24504791.

ABSTRACT: BACKGROUND: Reporting ototoxicity is frequently complicated by use of various ototoxicity criteria. The International Society of Pediatric Oncology (SIOP) ototoxicity grading scale was recently proposed for standardized use in reporting hearing loss outcomes across institutions. The aim of this study was to evaluate the concordance between the Chang and SIOP ototoxicity grading scales. Differences between the two scales were identified and the implications these differences may have in the clinical setting were discussed. PROCEDURES: Audiological evaluations were reviewed for 379 patients with newly diagnosed medulloblastoma (ages 3-21 years). Each patient was enrolled on one of two St. Jude clinical protocols that included craniospinal radiation therapy and four courses of 75 mg/m(2) cisplatin chemotherapy. The latest audiogram conducted 5.5-24.5 months post-protocol treatment initiation was graded using the Chang and SIOP ototoxicity criteria. Clinically significant hearing loss was defined as Chang grade ≥2a and SIOP ≥2. Hearing loss was considered serious (requiring a hearing aid) at the level of Chang grade ≥2b and SIOP ≥3. RESULTS: A strong concordance was observed between the Chang and SIOP ototoxicity scales (Stuart's tau-c statistic = 0.89, 95% CI: 0.86, 0.91). Among those patients diagnosed with serious hearing loss, the two scales were in good agreement. However, the scales deviated from one another in classifying patients with less serious or no hearing loss. CONCLUSIONS: Although discrepancies between the Chang and SIOP ototoxicity scales exist primarily for patients with no or minimal hearing loss, the scales share a strong concordance overall.

12 Article Examination of risk factors for intellectual and academic outcomes following treatment for pediatric medulloblastoma. 2014

Schreiber, Jane E / Gurney, James G / Palmer, Shawna L / Bass, Johnnie K / Wang, Mingjuan / Chen, Si / Zhang, Hui / Swain, Michelle / Chapieski, Mary L / Bonner, Melanie J / Mabbott, Donald J / Knight, Sarah J / Armstrong, Carol L / Boyle, Robyn / Gajjar, Amar. ·Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.) · Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.) · School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.) · Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B) · Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.) · Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.) · Royal Children's Hospital Brisbane, Herston, Australia (M.S.) · Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.) · Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.) · Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.) · Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.) · Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A) · Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.). ·Neuro Oncol · Pubmed #24497405.

ABSTRACT: BACKGROUND: The aim of this study was to prospectively examine the effects of hearing loss and posterior fossa syndrome (PFS), in addition to age at diagnosis and disease risk status, on change in intellectual and academic outcomes following diagnosis and treatment in a large sample of medulloblastoma patients. METHODS: Data from at least 2 cognitive and academic assessments were available from 165 patients (ages 3-21 years) treated with surgery, risk-adapted craniospinal irradiation, and 4 courses of chemotherapy with stem cell support. Patients underwent serial evaluation of cognitive and academic functioning from baseline up to 5 years post diagnosis. RESULTS: Serious hearing loss, PFS, younger age at diagnosis, and high-risk status were all significant risk factors for decline in intellectual and academic skills. Serious hearing loss and PFS independently predicted below-average estimated mean intellectual ability at 5 years post diagnosis. Patients with high-risk medulloblastoma and young age at diagnosis (<7 years) exhibited the largest drop in mean scores for intellectual and academic outcomes. CONCLUSIONS: Despite a significant decline over time, intellectual and academic outcomes remained within the average range at 5 years post diagnosis for the majority of patients. Future studies should determine if scores remain within the average range at time points further out from treatment. Patients at heightened risk should be closely monitored and provided with recommendations for appropriate interventions.

13 Article The role of inherited TPMT and COMT genetic variation in cisplatin-induced ototoxicity in children with cancer. 2013

Yang, J J / Lim, J Y S / Huang, J / Bass, J / Wu, J / Wang, C / Fang, J / Stewart, E / Harstead, E H / E, S / Robinson, G W / Evans, W E / Pappo, A / Zuo, J / Relling, M V / Onar-Thomas, A / Gajjar, A / Stewart, C F. ·Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. ·Clin Pharmacol Ther · Pubmed #23820299.

ABSTRACT: Ototoxicity is a debilitating side effect of platinating agents with substantial interpatient variability. We sought to evaluate the association of thiopurine S-methyltransferase (TPMT) and catechol O-methyltransferase (COMT) genetic variations with cisplatin-related hearing damage in the context of frontline pediatric cancer treatment protocols. In 213 children from the St. Jude Medulloblastoma-96 and -03 protocols, hearing loss was related to younger age (P = 0.013) and craniospinal irradiation (P = 0.001), but did not differ by TPMT or COMT variants. Results were similar in an independent cohort of 41 children from solid-tumor frontline protocols. Functional hearing loss or hair cell damage was not different in TPMT knockout vs. wild-type mice following cisplatin treatment, and neither TPMT nor COMT variant was associated with cisplatin cytotoxicity in lymphoblastoid cell lines. In conclusion, our results indicated that TPMT or COMT genetic variation was not related to cisplatin ototoxicity in children with cancer and did not influence cisplatin-induced hearing damage in laboratory models.

14 Article Carboplatin-associated ototoxicity in children with retinoblastoma. 2012

Qaddoumi, Ibrahim / Bass, Johnnie K / Wu, Jianrong / Billups, Catherine A / Wozniak, Amy W / Merchant, Thomas E / Haik, Barrett G / Wilson, Matthew W / Rodriguez-Galindo, Carlos. ·St Jude Children's Research Hospital, Memphis, TN 38105-3678, USA. ibrahim.qaddoumi@stjude.org ·J Clin Oncol · Pubmed #22370329.

ABSTRACT: PURPOSE: Carboplatin-induced ototoxicity remains poorly defined but is of potential great consequence in children with retinoblastoma. We retrospectively assessed the incidence of ototoxicity and its risk factors in children with retinoblastoma who were treated with carboplatin. PATIENTS AND METHODS: We reviewed the audiologic test results of 60 patients with retinoblastoma who received front-line treatment with systemic carboplatin and vincristine according to the St Jude RET-3 protocol (n = 23) or best clinical management (n = 37). Ototoxicity was evaluated by three different grading systems. RESULTS: Twelve patients (20%) developed ototoxicity at some time after treatment initiation; however, ototoxicity resolved in two patients, and thus,10 patients (17%) had sustained hearing loss as documented at their most recent audiologic evaluation. Nine of these 10 patients had grade 3 or 4 ototoxicity, and nine patients were less than 6 months of age at the start of chemotherapy. Age at the start of chemotherapy was the only risk factor identified as a significant predictor of sustained hearing loss. Younger age was associated with an increased incidence of hearing loss. The different ototoxicity grading systems showed good overall agreement in the identification of patients with ototoxicity. Agreement was greatest between the Brock and Children's Cancer Group systems. CONCLUSION: We found that young patients with retinoblastoma who were treated with systemic carboplatin had a higher incidence of ototoxicity than previously reported. Younger patients (< 6 months of age at the start of treatment) were more likely to have ototoxicity than were older patients. Children treated with carboplatin should routinely undergo thorough, long-term audiologic monitoring.

15 Article Monitoring carboplatin ototoxicity with distortion-product otoacoustic emissions in children with retinoblastoma. 2010

Bhagat, Shaum P / Bass, Johnnie K / White, Stephanie T / Qaddoumi, Ibrahim / Wilson, Matthew W / Wu, Jianrong / Rodriguez-Galindo, Carlos. ·School of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, United States. sbhagat@memphis.edu ·Int J Pediatr Otorhinolaryngol · Pubmed #20667604.

ABSTRACT: OBJECTIVE: Carboplatin is a common chemotherapy agent with potential ototoxic side effects that is used to treat a variety of pediatric cancers, including retinoblastoma. Retinoblastoma is a malignant tumor of the retina that is usually diagnosed in young children. Distortion-product otoacoustic emission tests offer an effective method of monitoring for ototoxicity in young children. This study was designed to compare measurements of distortion-product otoacoustic emissions obtained before and after several courses of carboplatin chemotherapy in order to examine if (a) mean distortion-product otoacoustic emission levels were significantly different; and (b) if criterion reductions in distortion-product otoacoustic emission levels were observed in individual children. METHODS: A prospective repeated measures study. Ten children with a median age of 7.6 months (range, 3-72 months) diagnosed with unilateral or bilateral retinoblastoma were examined. Distortion-product otoacoustic emissions were acquired from both ears of the children with 65/55 dB SPL primary tones (f(2)=793-7996 Hz) and a frequency resolution of 3 points/octave. Distortion-product otoacoustic emission levels in dB SPL were measured before chemotherapy treatment (baseline measurement) and after 3-4 courses of chemotherapy (interim measurement). Comparisons were made between baseline and interim distortion-product otoacoustic emission levels (collapsed across ears). Evidence of ototoxicity was based on criterion reductions (≥ 6 dB) in distortion-product otoacoustic emission levels. RESULTS: Significant differences between baseline and interim mean distortion-product otoacoustic emission levels were only observed at f(2) = 7996 Hz. Four children exhibited criterion reductions in distortion-product otoacoustic emission levels. CONCLUSIONS: Mean distortion-product otoacoustic emission levels at most frequencies were not changed following 3-4 courses of carboplatin chemotherapy in children with retinoblastoma. However, on an individual basis, children receiving higher doses of carboplatin exhibited criterion reductions in distortion-product otoacoustic emission level at several frequencies. These findings suggest that higher doses of carboplatin affect outer hair cell function, and distortion-product otoacoustic emission tests can provide useful information when monitoring children at risk of developing carboplatin ototoxicity.