Clinical Focus

  • Pediatric Hematology-Oncology

Academic Appointments

Honors & Awards

  • National Institutes of Health Pediatric Loan Repayment Award, National Cancer Institute (2013)

Boards, Advisory Committees, Professional Organizations

  • Early Career Council Member, American Society of Pediatric Hematology Oncology
  • Program Committee Member, American Society of Pediatric Hematology Oncology (2013 - Present)
  • Musculoskeletal/Functional Outcomes Task Force Member, Children's Oncology Group (2013 - Present)
  • Opsoclonus-Myoclonus-Ataxia Task Force Member, Children's Oncology Group (2013 - Present)
  • Oral/Dental Long-term Follow-up Guidelines Task Force Member, Children's Oncology Group (2012 - Present)
  • GI/Hepatic Long-term Follow-up Guidelines Task Force Member, Children's Oncology Group (2012 - Present)

Professional Education

  • Board Certification: Pediatric Hematology-Oncology, American Board of Pediatrics (2015)
  • Board Certification: Pediatrics, American Board of Pediatrics (2013)
  • Residency:Stanford University (2012) CA
  • Fellowship:Stanford University (2013) CA
  • Master of Science, Stanford University, Epidemiology and Clinical Research (2013)
  • Medical Education:New York Medical College (2006) NY

Research & Scholarship

Current Research and Scholarly Interests

Long-term Effects of Treatment on Survivors of Pediatric Cancers
Functional Outcomes in Pediatric Cancer Survivors
Adolescent and Young Adult Oncology
Opsoclonus-Myoclonus Ataxia Syndrome


Graduate and Fellowship Programs


All Publications

  • Divergent Patterns of Incidence in Peripheral Neuroblastic Tumors. Journal of pediatric hematology/oncology Merrihew, L. E., Fisher, P. G., Effinger, K. E. 2015; 37 (7): 502-506


    Prior research on trends in neuroblastoma incidence has conflicted. We aimed to compare how ganglioneuroblastoma and neuroblastoma incidence have changed.Using the Surveillance Epidemiology and End Results (SEER) 9 population-based registry, we identified 2081 malignant peripheral neuroblastic tumors in patients 0 to 14 years from 1973 to 2009. Age-adjusted annual incidence rates were calculated using SEER*Stat, and Joinpoint Regression Program was used to calculate annual percent change (APC) and analyze trends. Data were stratified by histology, age, and stage.Overall peripheral neuroblastic tumor incidence increased by an APC of 0.47 (P=0.045). However, ganglioneuroblastoma incidence decreased (APC=-1.48; P=0.003), whereas neuroblastoma incidence increased (APC=0.79; P=0.008). When divided by age and stage, locoregional neuroblastoma incidence increased in infants until a significant inflection point in 1996 (APC=4.19; P<0.001) and then decreased sharply (APC=-6.80; P=0.160).Ganglioneuroblastoma incidence has decreased, whereas neuroblastoma incidence has increased. These changes could be real, or reflect bias from classification changes or increased detection. Neuroblastoma incidence increased most markedly in infants with locoregional disease only until 1996, then declined, which may reflect changes in tumor ascertainment and folate supplementation.

    View details for DOI 10.1097/MPH.0000000000000383

    View details for PubMedID 26133942

  • Oral and dental late effects in survivors of childhood cancer: a Children's Oncology Group report SUPPORTIVE CARE IN CANCER Effinger, K. E., Migliorati, C. A., Hudson, M. M., McMullen, K. P., Kaste, S. C., Ruble, K., Guilcher, G. M., Shah, A. J., Castellino, S. M. 2014; 22 (7): 2009-2019


    Multi-modality therapy has resulted in improved survival for childhood malignancies. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers provide practitioners with exposure- and risk-based recommendations for the surveillance and management of asymptomatic survivors who are at least 2 years from completion of therapy. This review outlines the pathophysiology and risks for oral and dental late effects in pediatric cancer survivors and the rationale for oral and dental screening recommended by the Children's Oncology Group.An English literature search for oral and dental complications of childhood cancer treatment was undertaken via MEDLINE and encompassed January 1975 to January 2013. Proposed guideline content based on the literature review was approved by a multi-disciplinary panel of survivorship experts and scored according to a modified version of the National Comprehensive Cancer Network "Categories of Consensus" system.The Children's Oncology Group oral-dental panel selected 85 relevant citations. Childhood cancer therapy may impact tooth development, salivary function, craniofacial development, and temporomandibular joint function placing some childhood cancer survivors at an increased risk for poor oral and dental health. Additionally, head and neck radiation and hematopoietic stem cell transplantation increase the risk of subsequent malignant neoplasms in the oral cavity. Survivors require routine dental care to evaluate for potential side effects and initiate early treatment.Certain childhood cancer survivors are at an increased risk for poor oral and dental health. Early identification of oral and dental morbidity and early interventions can optimize health and quality of life.

    View details for DOI 10.1007/s00520-014-2260-x

    View details for Web of Science ID 000336936100034

    View details for PubMedID 24781353

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