Susan Kreissman

Overview:

The emphasis of Dr Kreissman's clinical research involves the study of childhood neuroblastoma. Neuroblastoma is the most common extracranial solid tumor of childhood and this disease has a diverse clinical phenotype and prognosis. Dr Kreissman has developed, written, and served as national protocol chairman for 2 clinical trials designed to improve outcome for children with the high risk form of this disease through the Children's Oncology Group (COG). Results of this protocol have been published " A Randomized Study of Purged Versus Unpurged Peripheral Blood Stem Cell Transplant Following Dose Intensive Induction Therapy for High Risk Neuroblastoma" and established the new standard of using unpurged PBSC to support autologous transplant in high risk neuroblastoma. Dr. Kreissman also serves as a member of the Neuroblastoma committees for COG. She is involved in designing and implimenting additional new protocols for the treatment of neuroblastoma.

Positions:

Professor of Pediatrics

Pediatrics, Hematology-Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1985

Icahn School of Medicine at Mount Sinai

Intern, Pediatrics

Children's Hospital Boston

Resident, Pediatrics

Children's Hospital Boston

Clinical Fellow, Pediatric Hematology/Oncology, Pediatrics

Children's Hospital Boston

Research Fellow, Pediatric Hematology/Oncology, Pediatrics

Children's Hospital Boston

Grants:

Stroma Biology Identifies Heparin as a Differentiating Agent in Neuroblastoma

Administered By
Medicine, Medical Oncology
Awarded By
Alex's Lemonade Stand
Role
Co Investigator
Start Date
End Date

COG Work Order AAML: 1031--Millennium Pharmaceuticals, Inc.

Administered By
Pediatrics, Hematology-Oncology
Awarded By
Children's Hospital of Philadelphia
Role
Principal Investigator
Start Date
End Date

COG Work Order: AALL1131: Ph III Clofarabine in High Risk B ALL

Administered By
Pediatrics, Hematology-Oncology
Awarded By
Children's Hospital of Philadelphia
Role
Principal Investigator
Start Date
End Date

NCI Community Oncology Research Program (NCORP) Research Base Grant

Administered By
Pediatrics, Hematology-Oncology
Awarded By
Children's Hospital of Philadelphia
Role
Principal Investigator
Start Date
End Date

COG WORK ORDER: (PROJECT: PEDIATRIC MATCH (APEC1621SC) PCR - COG FOUNDATION

Administered By
Pediatrics, Hematology-Oncology
Awarded By
Children's Hospital of Philadelphia
Role
Principal Investigator
Start Date
End Date

Publications:

Corrigendum to: LTBK-01. Updates On The Phase Ii And Re-treatment Study Of AZD6244 (Selumetinib) For Children With Recurrent Or Refractory Pediatric Low Grade Glioma: A Pediatric Brain Tumor Consortium (PBTC) Study.

Authors
Fangusaro, JR; Onar-Thomas, A; Poussaint, TY; Wu, S; Ligon, AH; Lindeman, NI; Banerjee, A; Packer, R; Kilburn, LB; Pollack, IF; Qaddoumi, IA; Fisher, PG; Dhall, G; Baxter, PA; Kreissman, SG; Doyle, LA; Smith, MA; Fouladi, M; Dunkel, IJ
URI
https://scholars.duke.edu/individual/pub1513210
PMID
35307742
Source
pubmed
Published In
Neuro Oncol
Volume
24
Published Date
Start Page
1404
DOI
10.1093/neuonc/noac029

Leveraging Clinical Informatics Tools to Extract Cumulative Anthracycline Exposure, Measure Cardiovascular Outcomes, and Assess Guideline Adherence for Children With Cancer.

PURPOSE: Cardiovascular disease is a significant cause of late morbidity and mortality in survivors of childhood cancer. Clinical informatics tools could enhance provider adherence to echocardiogram guidelines for early detection of late-onset cardiomyopathy. METHODS: Cancer registry data were linked to electronic health record data. Structured query language facilitated the construction of anthracycline-exposed cohorts at a single institution. Primary outcomes included the data quality from automatic anthracycline extraction, sensitivity of International Classification of Disease coding for heart failure, and adherence to echocardiogram guideline recommendations. RESULTS: The final analytic cohort included 385 pediatric oncology patients diagnosed between July 1, 2013, and December 31, 2018, among whom 194 were classified as no anthracycline exposure, 143 had low anthracycline exposure (< 250 mg/m2), and 48 had high anthracycline exposure (≥ 250 mg/m2). Manual review of anthracycline exposure was highly concordant (95%) with the automatic extraction. Among the unexposed group, 15% had an anthracycline administered at an outside institution not captured by standard query language coding. Manual review of echocardiogram parameters and clinic notes yielded a sensitivity of 75%, specificity of 98%, and positive predictive value of 68% for International Classification of Disease coding of heart failure. For patients with anthracycline exposure, 78.5% (n = 62) were adherent to guideline recommendations for echocardiogram surveillance. There were significant association with provider adherence and race and ethnicity (P = .047), and 50% of patients with Spanish as their primary language were adherent compared with 90% of patients with English as their primary language (P = .003). CONCLUSION: Extraction of treatment exposures from the electronic health record through clinical informatics and integration with cancer registry data represents a feasible approach to assess cardiovascular disease outcomes and adherence to guideline recommendations for survivors.
Authors
Noyd, DH; Berkman, A; Howell, C; Power, S; Kreissman, SG; Landstrom, AP; Khouri, M; Oeffinger, KC; Kibbe, WA
MLA Citation
Noyd, David H., et al. “Leveraging Clinical Informatics Tools to Extract Cumulative Anthracycline Exposure, Measure Cardiovascular Outcomes, and Assess Guideline Adherence for Children With Cancer.Jco Clin Cancer Inform, vol. 5, Oct. 2021, pp. 1062–75. Pubmed, doi:10.1200/CCI.21.00099.
URI
https://scholars.duke.edu/individual/pub1500431
PMID
34714665
Source
pubmed
Published In
Jco Clinical Cancer Informatics
Volume
5
Published Date
Start Page
1062
End Page
1075
DOI
10.1200/CCI.21.00099

More Than Meets the Eye? A Cautionary Tale of Malignant Ectomesenchymoma Treated as Low-risk Orbital Rhabdomyosarcoma.

Malignant ectomesenchymoma (MEM) is a rare multiphenotypic tumor comprised of mesenchymal and neuroectodermal components. MEM is typically diagnosed in infants and younger children and outcomes are variable. The current approach for treating MEM includes targeting the more aggressive mesenchymal component of the tumor, which is often rhabdomyosarcoma. Here, we describe a case of an orbital tumor initially diagnosed and treated as low-risk rhabdomyosarcoma. Local failure prompting a second biopsy revealed neuronal differentiation consistent with a diagnosis of MEM. Intensifying therapy and local radiotherapy led to a long-term cure. This case offers a cautionary tale that while outcomes for MEM were similar to matched rhabdomyosarcoma cohorts when treated on conventional Intergroup Rhabdomyosarcoma Study Group (IRSG) III/IV protocols, treating MEM using a decreased intensity low-risk rhabdomyosarcoma regimen may not be sufficient.
Authors
Rashid, T; Bagatell, R; Pawel, B; Bentley, RC; Kreissman, SG; Deel, MD
MLA Citation
Rashid, Tooba, et al. “More Than Meets the Eye? A Cautionary Tale of Malignant Ectomesenchymoma Treated as Low-risk Orbital Rhabdomyosarcoma.J Pediatr Hematol Oncol, vol. 43, no. 6, Aug. 2021, pp. e854–58. Pubmed, doi:10.1097/MPH.0000000000001901.
URI
https://scholars.duke.edu/individual/pub1454086
PMID
32769567
Source
pubmed
Published In
Journal of Pediatric Hematology/Oncology
Volume
43
Published Date
Start Page
e854
End Page
e858
DOI
10.1097/MPH.0000000000001901

Integration of cancer registry and electronic health record data to construct a childhood cancer survivorship cohort, facilitate risk stratification for late effects, and assess appropriate follow-up care.

BACKGROUND: This retrospective study harnessed an institutional cancer registry to construct a childhood cancer survivorship cohort, integrate electronic health record (EHR) and geospatial data to stratify survivors based on late-effect risk, analyze follow-up care patterns, and determine factors associated with suboptimal follow-up care. PROCEDURE: The survivorship cohort included patients ≤18 years of age reported to the institutional cancer registry between January 1, 1994 and November 30, 2012. International Classification of Diseases for Oncology, third revision (ICD-O-3) coding and treatment exposures facilitated risk stratification of survivors. The EHR was linked to the cancer registry based on medical record number (MRN) to extract clinic visits. RESULTS: Five hundred and ninety pediatric hematology-oncology (PHO) and 275 pediatric neuro-oncology (PNO) survivors were included in the final analytic cohort. Two hundred and eight-two survivors (32.6%) were not seen in any oncology-related subspecialty clinic at Duke 5-7 years after initial diagnosis. Factors associated with follow-up included age (p = .008), diagnosis (p < .001), race/ethnicity (p = .010), late-effect risk strata (p = .001), distance to treatment center (p < .0001), and area deprivation index (ADI) (p = .011). Multivariable logistic modeling attenuated the association for high-risk (OR 1.72; 95% CI 0.805, 3.66) and intermediate-risk (OR 1.23, 95% CI 0.644, 2.36) survivors compared to survivors at low risk of late effects among the PHO cohort. PNO survivors at high risk for late effects were more likely to follow up (adjusted OR 3.66; 95% CI 1.76, 7.61). CONCLUSIONS: Nearly a third of survivors received suboptimal follow-up care. This study provides a reproducible model to integrate cancer registry and EHR data to construct risk-stratified survivorship cohorts to assess follow-up care.
Authors
Noyd, DH; Neely, NB; Schroeder, KM; Lantos, PM; Power, S; Kreissman, SG; Oeffinger, KC
URI
https://scholars.duke.edu/individual/pub1476847
PMID
33742534
Source
pubmed
Published In
Pediatr Blood Cancer
Volume
68
Published Date
Start Page
e29014
DOI
10.1002/pbc.29014

Prospective Evaluation of Radiation Dose Escalation in Patients With High-Risk Neuroblastoma and Gross Residual Disease After Surgery: A Report From the Children's Oncology Group ANBL0532 Study.

PURPOSE: A primary objective of the Children's Oncology Group (COG) ANBL0532 phase III study was to assess the effect of increasing local dose of radiation to a residual primary tumor on the cumulative incidence of local progression (CILP) in patients with high-risk neuroblastoma. PATIENTS AND METHODS: Newly diagnosed patients with high-risk neuroblastoma were randomly assigned or assigned to receive single or tandem autologous stem-cell transplantation (SCT) after induction chemotherapy. Local control consisted of surgical resection during induction chemotherapy and radiotherapy after last SCT. Patients received 21.6 Gy to the preoperative primary tumor volume. For patients with incomplete surgical resection, an additional boost of 14.4 Gy was delivered to the gross residual tumor, for a total dose of 36 Gy. CILP (primary end point) and event-free (EFS) and overall survival (OS; secondary end points) were compared with the COG A3973 historical cohort, in which all patients received single SCT and 21.6 Gy without a boost. RESULTS: For all patients in ANBL0532 receiving radiotherapy (n = 323), 5-year CILP, EFS, and OS rates were 11.2% ± 1.8%, 56.2% ± 3.4%, and 68.4% ± 3.2% compared with 7.1% ± 1.4% (P = .0590), 47.0% ± 3.5% (P = .0090), and 57.4% ± 3.5% (P = .0088) for all patients in A3973 receiving radiotherapy (n = 328), respectively. Five-year CILP, EFS, and OS rates for patients in A3973 with incomplete resection and radiotherapy (n = 47) were 10.6% ± 4.6%, 48.9% ± 10.1%, and 56.9% ± 10.0%, respectively. In comparison, 5-year CILP, EFS, and OS rates for patients in ANBL0532 who were randomly assigned or assigned to single SCT and received boost radiotherapy (n = 74) were 16.3% ± 4.3% (P = .4126), 50.9% ± 7.0% (P = .5084), and 68.1% ± 6.7% (P = .2835), respectively. CONCLUSION: Boost radiotherapy to gross residual tumor present at the end of induction did not significantly improve 5-year CILP. These results highlight the need for new strategies to decrease the risk of locoregional failure.
Authors
Liu, KX; Naranjo, A; Zhang, FF; DuBois, SG; Braunstein, SE; Voss, SD; Khanna, G; London, WB; Doski, JJ; Geiger, JD; Kreissman, SG; Grupp, SA; Diller, LR; Park, JR; Haas-Kogan, DA
MLA Citation
URI
https://scholars.duke.edu/individual/pub1448417
PMID
32530765
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
38
Published Date
Start Page
2741
End Page
2752
DOI
10.1200/JCO.19.03316