Location, symptoms, and management of plexiform neurofibromas in 127 children with neurofibromatosis 1, attending the National Complex Neurofibromatosis 1 service, 2018-2019
- PMID: 35178860
- DOI: 10.1002/ajmg.a.62691
Location, symptoms, and management of plexiform neurofibromas in 127 children with neurofibromatosis 1, attending the National Complex Neurofibromatosis 1 service, 2018-2019
Abstract
We report on the location, symptoms, and management of plexiform neurofibroma (PN) in children with Neurofibromatosis Type 1 (NF1) attending the 2 National Complex Neurofibromatosis 1 Services at Guy's and St. Thomas' NHS Foundation Trust, London and St Mary's Hospital, Manchester. Retrospective data collection was performed from patient chart reviews from April 2018 to April 2019. There were 127 NF1 patients with PN, age range 0.8-17.0, mean age was 9.9 years (SD ± 4.2 years). The main location of the PN was craniofacial in 35%, and limb in 19%. Disfigurement was present in 57%, pain in 28%, impairment of function in 23%, and threat to function in 9% of children. Fifty-four percent of patients were managed conservatively, 28% surgically, and 19% are either taking or due to start a mitogen-activated protein kinase kinase (MEK) inhibitor (selumetinib or trametinib), either through a clinical trial or compassionate usage scheme. This national study provides a comprehensive overview of the management of children with PN in an era where new therapies (MEK inhibitors) are becoming more widely available. We anticipate that there will be a shift to more patients receiving MEK inhibitor therapy and combination therapy (surgery and MEK inhibitor) in the future.
Keywords: location; management; neurofibromatosis type 1; plexiform neurofibroma; symptom.
© 2022 Wiley Periodicals LLC.
References
REFERENCES
-
- Anastasaki, C., & Gutmann, D. H. (2014). Neuronal NF1/RAS regulation of cyclic AMP requires atypical PKC activation. Human Molecular Genetics, 23(25), 6712-6721. https://doi.org/10.1093/hmg/ddu389
-
- Basu, T. N., Gutmann, D. H., Fletcher, J. A., Glover, T. W., Collins, F. S., & Downward, J. (1992). Aberrant regulation of ras proteins in malignant tumour cells from type 1 neurofibromatosis patients. Nature, 356, 713-715. https://doi.org/10.1038/356713a0
-
- Dasputa, B., Yi, Y., Chen, D. Y., Weber, J. D., & Gutmann, D. H. (2005). Proteomic analysis reveals Hyperactivation of the mammalian target of rapamycin pathway in Neurofibromatosis 1-associated human and mouse brain Tumours. Cancer Research, 65(7), 2755-2760. https://doi.org/10.1158/0008-5472.CAN-04-4058
-
- Dombi, E., Baldwin, A., Marcus, L. J., Fisher, M. J., Weiss, B., Kim, A., Whitcomb, P., Martin, S., Aschbacher-Smith, L. E., Rizvi, T. A., Wu, J., Ershler, R., Wolters, P., Therrien, J., Glod, J., Belasco, J. B., Schorry, E., Brofferio, A., Starosta, A. J., … Widemann, B. C. (2016). Activity of Selumetinib in Neurofibromatosis type 1-related plexiform Neurofibromas. New England Journal of Medicine, 375(26), 2550-2560. https://doi.org/10.1056/NEJMoa1605943
-
- Donovan, S., See, W., Bonifas, J., Stokoe, D., & Shannon, K. M. (2002). Hyperactivation of protein kinase B and ERK have discrete effects on survival, proliferation and cytokine expression in NF1-deficient myeloid cells. Cancer Cell, 2(6), 507-514. https://doi.org/10.1016/s1535-6108(02)00214-3
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Research Materials
Miscellaneous
