Evaluation of a Noninvasive Hemoglobin Measurement Device to Screen for Anemia in Infancy.

OBJECTIVE: Iron deficiency is the most prevalent micronutrient deficiency worldwide and a common medical condition in the United States. The American Academy of Pediatrics has recommended universal screening for iron deficiency anemia in infants at approximately 1 year of age. This screening involves invasive venous blood sampling which increases the clinic visit time and may cause significant stress to the patient and family members. The purpose of this study was to assess the accuracy and utility of a non-invasive hemoglobin measurement device compared to standard laboratory hemoglobin measurement from venipuncture. METHODS: One hundred ten children were enrolled in the study following a well-child examination at San Antonio Military Medical Center from June 2012 to June 2014. Each child had a hemoglobin measurement obtained with the Masimo Pronto with Rainbow(®) R20L disposable sensor followed by venipuncture that was sent to the clinical laboratory for hemoglobin measurement. Paired hemoglobin results from the non-invasive device and the clinical laboratory were compared. RESULTS: Ninety-seven children successfully had hemoglobin measured by the Masimo Pronto device. Hemoglobin values obtained with the Masimo Pronto were significantly correlated with venous hemoglobin levels, with a correlation coefficient of 0.48. A hemoglobin level less than 11.5 gm/dL on the Masimo Pronto had a sensitivity of 82 % and a negative predictive value of 95 % when compared to venous hemoglobin level less than 11 gm/dL. CONCLUSIONS: for Practice Non-invasive hemoglobin testing with the Masimo Pronto device may be a useful screening tool for anemia in infants that avoids invasive testing.

Comprehensive characterization of patient-derived xenograft models of pediatric leukemia.

Patient-derived xenografts (PDX) remain valuable models for understanding the biology and for developing novel therapeutics. To expand current PDX models of childhood leukemia, we have developed new PDX models from Hispanic patients, a subgroup with a poorer overall outcome. Of 117 primary leukemia samples obtained, successful engraftment and serial passage in mice were achieved in 82 samples (70%). Hispanic patient samples engrafted at a rate (51/73, 70%) that was similar to non-Hispanic patient samples (31/45, 70%). With a new algorithm to remove mouse contamination in multi-omics datasets including methylation data, we found PDX models faithfully reflected somatic mutations, copy-number alterations, RNA expression, gene fusions, whole-genome methylation patterns, and immunophenotypes found in primary tumor (PT) samples in the first 50 reported here. This cohort of characterized PDX childhood leukemias represents a valuable resource in that germline DNA sequencing has allowed the unambiguous determination of somatic mutations in both PT and PDX.

Scalp metastasis of paraspinal alveolar rhabdomyosarcoma.

We describe a 10-year-old girl with paraspinal alveolar rhabdomyosarcoma (RMS) who presented with an asymptomatic soft tissue mass on the left aspect of the parietal scalp of 2 weeks' duration. Biopsy demonstrated metastasis of her RMS. A full-body positron emission tomography (PET) scan revealed multiple areas of increased uptake consistent with extensive metastases. We also discuss the literature on RMS classification and metastasis to the skin.