BackgroundA previous study reported increased dissatisfaction with hospital care for children with sickle cell disease (SCD); however, its small size excluded determining whether race and chronic disease explained the difference.ProcedureAt hospital discharge, parents of children with SCD completed a survey assessing satisfaction with their child's hospital care. Results were compared to three years of satisfaction surveys for children with asthma or admitted to a general pediatrician's service collected as quality improvement for the hospital. The primary outcome was parent reported dissatisfaction with care. A chi‐square was used to compare dissatisfaction between SCD and each comparison group.ResultsParents of 639 children were included, 34 children with SCD, 124 with asthma, and 481 general pediatric patients. Parents of children with SCD were more often dissatisfied with their child's care compared to children with asthma (32.4% vs. 16.9%, P < 0.05) and general pediatric patients (32.4% vs. 14.6%, P < 0.05). Among all children, dissatisfaction was higher in families with minority children (21.1% vs. 12.6%); this difference did not exist among children with asthma. Among African‐American children, a higher proportion of parents of children with SCD believed their child was treated differently because of race than children with asthma (45.5% vs. 2.8%, P < 0.01) or general pediatric patients (45.5% vs. 8.3%, P < 0.01).ConclusionParents of children with SCD report increased dissatisfaction with care. While dissatisfaction was higher in minority families, the high rate of parental concern about race as a reason for families of children with SCD is not seen in African‐American families of children with asthma. Pediatr Blood Cancer 2009;53:174–178. © 2009 Wiley‐Liss, Inc.

1089 Background: Limited data exists to establish if the introduction of newer agents has been associated with a trend towards an improved OS over time in women with MBC. Methods: Trough a computer-based systematic search of PubMed we identified RCT that treated patients with MBC published between 1980 and 2011. Trials that compared systemic chemotherapy for MBC, and reported a median OS were included. We excluded trials that use concomitant hormonal treatment, investigated only immunotherapy, or if they enrolled only responders to an initial regimen. The data abstracted included: year of publication, number of patients, regimens used, number of patient treated as 1st line vs. refractory patients, median PFS, TTP and OS. Linear regression analysis was used to establish trends. Results: An initial searched revealed 5485 publications, 134 RCT that enrolled 38,090 patients fulfilled our entry criteria and were included. First line therapy was studied in 99 trials and 35 evaluated mostly refractory patients. The use of adjuvant therapy has increased substantially, trials reported in the 1980’s had a mean of 0.07% of patients having had adjuvant chemotherapy compare to a mean of 48% in the last decade. Overall survival has significantly improved; the slope of the fitted line for first line clinical trials was 0.39 (p<0.001), which indicates a 0.39-month increase in median survival time per year. In trials of subsequent lines of therapy this slope was 0.19 (p=0.001). PFS or TTP was reported in 98 trials, interestingly in contrast to OS, this has not significantly changed, the slope for the fitted line has remained almost flat in both first line (0.002, p=0.97) and refractory trials (0.01, P=0.81). Conclusions: Our study is the first of its kind conducted in trials of patients with MBC. It shows that progress has been made in the last 3 decades OS in women affected with MBC, however the lack of change in PFS or TTP appears to indicate that the increase in OS is driven by a combination of newer agents, more subsequent lines of therapy being offered to patients and improved palliative care.