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Rapid autopsy of a patient with recurrent anaplastic ependymoma

Published online by Cambridge University Press:  25 September 2017

Katharine Rae Lange ,
Cheryl Fischer ,
Prajwal Rajappa ,
Scott Connors ,
David Pisapia ,
Jeffrey P. Greenfield ,
Himisha Beltran ,
Mark Rubin ,
Juan Miguel Mosquera  and
Yasmin Khakoo
Katharine Rae Lange*
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, New York
Cheryl Fischer
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, New York
Prajwal Rajappa
Affiliation:
New York–Presbyterian/Weill Cornell Medical Center, New York, New York
Scott Connors
Affiliation:
New York–Presbyterian/Weill Cornell Medical Center, New York, New York
David Pisapia
Affiliation:
New York–Presbyterian/Weill Cornell Medical Center, New York, New York
Jeffrey P. Greenfield
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, New York New York–Presbyterian/Weill Cornell Medical Center, New York, New York
Himisha Beltran
Affiliation:
New York–Presbyterian/Weill Cornell Medical Center, New York, New York
Mark Rubin
Affiliation:
New York–Presbyterian/Weill Cornell Medical Center, New York, New York
Juan Miguel Mosquera
Affiliation:
New York–Presbyterian/Weill Cornell Medical Center, New York, New York
Yasmin Khakoo
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, New York New York–Presbyterian/Weill Cornell Medical Center, New York, New York
*
Address correspondence and reprint requests to: Katharine Rae Lange, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, New York 10065. E-mail: raek@mskcc.org.
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Abstract

Objective:

Our aim was to outline a procedure for obtaining a rapid autopsy in order to collect high-quality postmortem tissue for genomic analysis.

Methods:

This report details a bi-institutional collaborative effort to coordinate a rapid autopsy for a pediatric patient who had died at home. We discuss the scientific rationale for offering a rapid autopsy to caregivers of pediatric patients as well as parental perspectives on broaching the subject of autopsy. We then review the logistics and coordination involved with planning a rapid autopsy and the sequence of events needed to maximize tissue quality.

Results:

We report the successful coordination of a rapid autopsy for a patient who died in a hospice setting at her out-of-state home. The time interval from death to the start of the rapid autopsy procedure was 4.5 hours, despite the logistical considerations demanded by the location of the patient. Tumor aliquots and nonneoplastic tissues were successfully snap frozen for downstream genomic studies.

Significance of Results:

Physicians should consider trialing a rapid autopsy program at their institution that could be offered to caregivers of pediatric patients. This case report offers a framework to help clinicians develop their own rapid autopsy programs as well as guidelines to help streamline this process for appropriate candidates going forward.

Keywords

PediatricHospiceAutopsyCommunicationNeurooncology
Type
Case Report
Information
Palliative & Supportive Care , Volume 16 , Issue 2 , April 2018 , pp. 238 - 242
Copyright
Copyright © Cambridge University Press 2017 

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References

REFERENCES

Alabran, J. L., Hooper, J. E., Hill, M., et al. (2013). Overcoming autopsy barriers in pediatric cancer research. Pediatric Blood & Cancer, 60(2), 204–209.CrossRefGoogle ScholarPubMed
Baker, J. N., Windham, J. A., Hinds, P. S., et al. (2013). Bereaved parents' intentions and suggestions about research autopsies in children with lethal brain tumors. The Journal of Pediatrics, 163(2), 581–586.CrossRefGoogle ScholarPubMed
Beltran, H., Eng, K., Mosquera, J. M., et al. (2015). Whole-exome sequencing of metastatic cancer and biomarkers of treatment response. JAMA Oncology, 1(4), 466–474.CrossRefGoogle ScholarPubMed
Broniscer, A., Baker, J. N., Baker, S. J., et al. (2010). Prospective collection of tissue samples at autopsy in children with diffuse intrinsic pontine glioma. Cancer, 116(19), 4632–4637.CrossRefGoogle ScholarPubMed
Carter, A., Landier, W., Schad, A., et al. (2008). Successful coordination and execution of nontherapeutic studies in a cooperative group setting: Lessons learned from Children's Oncology Group studies. Cancer Epidemiology, Biomarkers & Prevention, 17(7), 1665–1673.CrossRefGoogle Scholar
Faltas, B. M., Prandi, D., Tagawa, S. T., et al. (2016). Clonal evolution of chemotherapy-resistant urothelial carcinoma. Nature Genetics, 48(12), 1490–1499.CrossRefGoogle ScholarPubMed
Kambhampati, M., Perez, J. P., Yadavilli, S., et al. (2015). A standardized autopsy procurement allows for the comprehensive study of DIPG biology. Oncotarget, 6(14), 12740–12747.CrossRefGoogle ScholarPubMed
Mack, S. C., Witt, H., Piro, R. M., et al. (2014). Epigenomic alterations define lethal CIMP-positive ependymomas of infancy. Nature, 506(7489), 445–450.CrossRefGoogle ScholarPubMed
Pisapia, D. J., Salvatore, S., Pauli, C., et al. (2017). Next-generation rapid autopsies enable tumor evolution tracking and generation of preclinical models. JCO Precision Oncology, 1, 1–13. Available from http://ascopubs.org/doi/full/10.1200/PO.16.00038.CrossRefGoogle Scholar
Spunt, S. L., Vargas, S. O., Coffin, C. M., et al. (2012). The clinical, research, and social value of autopsy after any cancer death: A perspective from the Children's Oncology Group Soft Tissue Sarcoma Committee. Cancer, 118(12), 3002–3009.CrossRefGoogle Scholar
Wiener, L., Sweeney, C., Baird, K., et al. (2014). What do parents want to know when considering autopsy for their child with cancer? Journal of Pediatric Hematology/Oncology, 36(6), 464–470.CrossRefGoogle ScholarPubMed