The main areas of research activity for 2000 can be briefly summarized as follows:

The two large pediatric oncology groups (Children’s Oncology Group, CCG and the Pediatric Oncology Group, POG), and two smaller disease-specific groups (NWTS and IRSG) merged in 2000 to form a single, nation-wide pediatric oncology group – COG. Coincident with this merger, the NCI is sponsoring development of a national pediatric cancer registry and research network (the Children’s Cancer research Network, CCRN), and Dr.s Buckley, Deapen and Bernstein at USC are playing key roles in the establishment of the registry. This resource is expected to provide the entral focus for a broad range of research into the incidence and cause of childhood cancers in the U.S. and Canada.

The molecular epidemiological study of pesticides and childhood non-Hodgkin's lymphoma described in the last report (Buckley, PI) is currently on-going. Other CCG related studies include proposed case-control studies of hepatoblastoma and brain tumors (VanTornout and Buckley) and two studies being conducted out of the University of Minnesota (Julie Ross, P.I.) for which Dr. Buckley is a co-investigator (a case-control study of Downs syndrome/leukemia and an infant leukemia case/control study to examine the role of exposure to topoisomerase inhibitors).

Dr. Preston-Martin's main area of interest remains childhood brain tumors. She coordinated a multi-national case-control study of brain tumors, including 1218 cases and 2223 controls at 9 centers, and much of her energies in recent years has been focused on a complete and through analysis of the data from that study. Analysis of this data set in continuing.

Members of this group, and particularly Dr. Van Tornout, continue to conduct research related to genetic susceptibility to childhood cancer. Current projects include studies of neuroblastoma, brain tumors, and Ewing’s sarcoma. An R01 application has been submitted to study selected metabolic polymorphisms in children with brain tumors where the involvement of MTHFR raises the intriguing possibility of a gene-environment interaction between this key enzyme of folate metabolism and level of folate intake during pregnancy. Consultation with the Biostatistics Core was particularly vital in the design of this study, since the study needed to be able to address the potential role of the case’s genotype, the mother’s genotype, the case’s exposures and the mother’s exposures, as well as interactions.

Dr. Bhatia continues her interest and involvement studies on second malignancies for children with cancer, including studies Hodgkin's disease survivors, who are at very high risk of secondary breast cancer, and second neoplasms following childhood ALL and bone marrow transplantation. She is collaborating with Dr. Buckley in developing a database of SMN patients in CCG, to identify cases, construct a pedigree, and correlate risk with socio-demographic, clinical and treatment characteristics.

The NIEHS Center has served to bring particular focus to issues of exposure assessment in childhood cancer. This is a critical issue, made all the more difficult because of the wide geographic spread of cases and controls in most studies that are conducted. The impracticality of direct exposure assessment has forced investigators to refine, as much as possible, the questionnaire tools at their disposal. Where direct measurement of environmental exposures have been possible, studies have been designed to capitalize on the opportunity. This applies to studies on EMF exposure (carried out in Los Angeles county by Dr. John Peters and others, and nationally by Dr. Linet, in collaboration with Dr. Robison and Dr. Buckley), radon exposure (in collaboration with NCI and NIEHS) and pesticide, PAH, metals and ETS exposure (through house dust sampling).