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Risk-based health monitoring of childhood cancer survivors: A report from the children’s oncology group

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Abstract

Because of therapeutic advances over the past 50 years, long-term survival is now a reality for nearly 80% of children and adolescents diagnosed with cancer. The growing population of childhood cancer survivors is notable for its vulnerability to adverse health outcomes, many of which may not become clinically apparent until years after therapy completion. Early detection, prevention, and ameliorative interventions provide the opportunity to reduce cancer-related morbidity and mortality. This review is intended to complement the Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers. The objective of this review is to familiarize readers with the diverse health risks experienced by childhood cancer survivors that stem from the heterogeneous therapeutic interventions required to achieve disease control.

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References and Recommended Reading

  1. Jemal A, Siegel R, Ward E, et al.: Cancer statistics, 2006. CA Cancer J Clin 2006, 56:106–130.

    Article  PubMed  Google Scholar 

  2. Hudson MM, Mertens AC, Yasui Y, et al.: Health status of adult long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. JAMA 2003, 290:1583–1592.

    Article  PubMed  CAS  Google Scholar 

  3. Mertens AC: Cause of mortality in 5-year survivors of childhood cancer. Pediatr Blood Cancer 2007, 48:723–726.

    Article  PubMed  Google Scholar 

  4. Oeffinger KC, Hudson MM: Long-term complications following childhood and adolescent cancer: foundations for providing risk-based health care for survivors. CA Cancer J Clin 2004, 54:208–236.

    PubMed  Google Scholar 

  5. Oeffinger KC, Mertens AC, Sklar CA, et al.: Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 2006, 355:1572–1582.

    Article  PubMed  CAS  Google Scholar 

  6. Geenen MM, Cardous-Ubbink MC, Kremer LC, et al.: Medical assessment of adverse health outcomes in long-term survivors of childhood cancer. JAMA 2007, 297:2705–2715.

    Article  PubMed  CAS  Google Scholar 

  7. Landier W, Bhatia S, Eshelman DA, et al.: Development of risk-based guidelines for pediatric cancer survivors: the Children’s Oncology Group Long-Term Follow-Up Guidelines from the Children’s Oncology Group Late Effects Committee and Nursing Discipline. J Clin Oncol 2004, 22:4979–4990. Accessible at http://www.survivorshipguidelines.org.

    Article  PubMed  Google Scholar 

  8. Darzy KH, Shalet SM: Hypopituitarism after cranial irradiation. J Endocrinol Invest 2005, 28(5 Suppl):78–87.

    PubMed  CAS  Google Scholar 

  9. Schmiegelow M: Endocrinological late effects following radiotherapy and chemotherapy of childhood brain tumours. Dan Med Bull 2006, 53:326–341.

    PubMed  Google Scholar 

  10. Brouwer CA, Gietema JA, Kamps WA, et al.: Changes in body composition after childhood cancer treatment: impact on future health status—a review. Crit Rev Oncol Hematol 2007, 63:32–46.

    Article  PubMed  CAS  Google Scholar 

  11. Sigurdson AJ, Ronckers CM, Mertens AC, et al.: Primary thyroid cancer after a first tumour in childhood (the Childhood Cancer Survivor Study): a nested case-control study. Lancet 2005, 365:2014–2023.

    Article  PubMed  Google Scholar 

  12. Sklar C, Whitton J, Mertens A, et al.: Abnormalities of the thyroid in survivors of Hodgkin’s disease: data from the Childhood Cancer Survivor Study. J Clin Endocrinol Metab 2000, 85:3227–3232.

    Article  PubMed  CAS  Google Scholar 

  13. Chemaitilly W, Mertens AC, Mitby P, et al.: Acute ovarian failure in the childhood cancer survivor study. J Clin Endocrinol Metab 2006, 91:1723–1728.

    Article  PubMed  CAS  Google Scholar 

  14. Sklar C: Maintenance of ovarian function and risk of premature menopause related to cancer treatment. J Natl Cancer Inst Monogr 2005, 34:25–27.

    Article  PubMed  Google Scholar 

  15. Sklar C: Reproductive physiology and treatment-related loss of sex hormone production. Med Pediatr Oncol 1999, 33:2–8.

    Article  PubMed  CAS  Google Scholar 

  16. Kaste SC, Ahn H, Liu T, et al.: Bone mineral density deficits in pediatric patients treated for sarcoma. Pediatr Blood Cancer 2007 [Epub ahead of print].

  17. Kaste SC, Jones-Wallace D, Rose SR, et al.: Bone mineral decrements in survivors of childhood acute lymphoblastic leukemia: frequency of occurrence and risk factors for their development. Leukemia 2001, 15:728–734.

    Article  PubMed  CAS  Google Scholar 

  18. Kaste SC, Shidler TJ, Tong X, et al.: Bone mineral density and osteonecrosis in survivors of childhood allogeneic bone marrow transplantation. Bone Marrow Transplant 2004, 33:435–441.

    Article  PubMed  CAS  Google Scholar 

  19. Sala A, Mattano LA Jr, Barr RD: Osteonecrosis in children and adolescents with cancer: an adverse effect of systemic therapy. Eur J Cancer 2007, 43:683–689.

    Article  PubMed  Google Scholar 

  20. Relling MV, Yang W, Das S, et al.: Pharmacogenetic risk factors for osteonecrosis of the hip among children with leukemia. J Clin Oncol 2004, 22:3930–3936.

    Article  PubMed  Google Scholar 

  21. Kremer LC, van der Pal HJ, Offringa M, et al.: Frequency and risk factors of subclinical cardiotoxicity after anthracycline therapy in children: a systematic review. Ann Oncol 2002, 13:819–829.

    Article  PubMed  CAS  Google Scholar 

  22. Lipshultz SE, Lipsitz SR, Mone SM, et al.: Female sex and drug dose as risk factors for late cardiotoxic effects of doxorubicin therapy for childhood cancer. N Engl J Med 1995, 332:1738–1743.

    Article  PubMed  CAS  Google Scholar 

  23. Lipshultz SE, Colan SD, Gelber RD, et al.: Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood. N Engl J Med 1991, 324:808–815.

    Article  PubMed  CAS  Google Scholar 

  24. Kremer LC, van Dalen EC, Offringa M, et al.: Anthracycline-induced clinical heart failure in a cohort of 607 children: long-term follow-up study. J Clin Oncol 2001, 19:191–196.

    PubMed  CAS  Google Scholar 

  25. Hull MC, Morris CG, Pepine CJ, Mendenhall NP: Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of Hodgkin lymphoma treated with radiation therapy. JAMA 2003, 290:2831–2837.

    Article  PubMed  CAS  Google Scholar 

  26. Berry GJ, Jorden M: Pathology of radiation and anthracycline cardiotoxicity. Pediatr Blood Cancer 2005, 44:630–637.

    Article  PubMed  Google Scholar 

  27. Schwartz CL, Hobbie WL, Truesdell S, et al.: Corrected QT interval prolongation in anthracycline-treated survivors of childhood cancer. J Clin Oncol 1993, 11:1906–1910.

    PubMed  CAS  Google Scholar 

  28. Bianchetti MG, Kanaka C, Ridolfi-Luthy A, et al.: Persisting renotubular sequelae after cisplatin in children and adolescents. Am J Nephrol 1991, 11:127–130.

    PubMed  CAS  Google Scholar 

  29. Marina NM, Poquette CA, Cain AM, et al.: Comparative renal tubular toxicity of chemotherapy regimens including ifosfamide in patients with newly diagnosed sarcomas. J Pediatr Hematol Oncol 2000, 22:112–118.

    Article  PubMed  CAS  Google Scholar 

  30. Skinner R: Chronic ifosfamide nephrotoxicity in children. Med Pediatr Oncol 2003, 41:190–197.

    Article  PubMed  CAS  Google Scholar 

  31. Smith GR, Thomas PR, Ritchey M, Norkool P: Long-term renal function in patients with irradiated bilateral Wilms tumor. National Wilms’ Tumor Study Group. Am J Clin Oncol 1998, 21:58–63.

    Article  PubMed  CAS  Google Scholar 

  32. Ritchey ML, Green DM, Thomas PR, et al.: Renal failure in Wilms’ tumor patients: a report from the National Wilms’ Tumor Study Group. Med Pediatr Oncol 1996, 26:75–80.

    Article  PubMed  CAS  Google Scholar 

  33. Yeung CK, Ward HC, Ransley PG, et al.: Bladder and kidney function after cure of pelvic rhabdomyosarcoma in childhood. Br J Cancer 1994, 70:1000–1003.

    PubMed  CAS  Google Scholar 

  34. Pedersen-Bjergaard J, Ersboll J, Hansen VL, et al.: Carcinoma of the urinary bladder after treatment with cyclophosphamide for non-Hodgkin’s lymphoma. N Engl J Med 1988, 318:1028–1032.

    Article  PubMed  CAS  Google Scholar 

  35. Mahboubi S, Silber JH: Radiation-induced esophageal strictures in children with cancer. Eur Radiol 1997, 7:119–122.

    Article  PubMed  CAS  Google Scholar 

  36. Raney B Jr, Heyn R, Hays DM, et al.: Sequelae of treatment in 109 patients followed for 5 to 15 years after diagnosis of sarcoma of the bladder and prostate. A report from the Intergroup Rhabdomyosarcoma Study Committee. Cancer 1993, 71:2387–2394.

    Article  PubMed  Google Scholar 

  37. Broxson EH, Dole M, Wong R, et al.: Portal hypertension develops in a subset of children with standard risk acute lymphoblastic leukemia treated with oral 6-thioguanine during maintenance therapy. Pediatr Blood Cancer 2005, 44:226–231.

    Article  PubMed  Google Scholar 

  38. Green DM, Norkool P, Breslow NE, et al.: Severe hepatic toxicity after treatment with vincristine and dactinomycin using single-dose or divided-dose schedules: a report from the National Wilms’ Tumor Study. J Clin Oncol 1990, 8:1525–1530.

    PubMed  CAS  Google Scholar 

  39. Castellino S, Lensing S, Riely C, et al.: The epidemiology of chronic hepatitis C infection in survivors of childhood cancer: an update of the St. Jude Children’s Research Hospital hepatitis C seropositive cohort. Blood 2004, 103:2460–2466.

    Article  PubMed  CAS  Google Scholar 

  40. Kreisman H, Wolkove N: Pulmonary toxicity of antineoplastic therapy. Semin Oncol 1992, 19:508–520.

    PubMed  CAS  Google Scholar 

  41. Lund MB, Kongerud J, Nome O, et al.: Lung function impairment in long-term survivors of Hodgkin’s disease. Ann Oncol 1995, 6:495–501.

    PubMed  CAS  Google Scholar 

  42. Marina NM, Greenwald CA, Fairclough DL, et al.: Serial pulmonary function studies in children treated for newly diagnosed Hodgkin’s disease with mantle radiotherapy plus cycles of cyclophosphamide, vincristine, and procarbazine alternating with cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine. Cancer 1995, 75:1706–1711.

    Article  PubMed  CAS  Google Scholar 

  43. Knight KR, Kraemer DF, Neuwelt EA: Ototoxicity in children receiving platinum chemotherapy: underestimating a commonly occurring toxicity that may influence academic and social development. J Clin Oncol 2005, 23:8588–8596.

    Article  PubMed  Google Scholar 

  44. Punnett A, Bliss B, Dupuis LL, et al.: Ototoxicity following pediatric hematopoietic stem cell transplantation: a prospective cohort study. Pediatr Blood Cancer 2004, 42:598–603.

    Article  PubMed  Google Scholar 

  45. Johannesen TB, Rasmussen K, Winther FO, et al.: Late radiation effects on hearing, vestibular function, and taste in brain tumor patients. Int J Radiat Oncol Biol Phys 2002, 53:86–90.

    PubMed  Google Scholar 

  46. Ober M, Servodidio CA, Abramson DH: Ocular complications due to cancer treatment. In Survivors of Childhood and Adolescent Cancer: A Multidisciplinary Approach. Edited by Schwartz CL, Hobbie WL, Constine LS, Ruccione KS. Heidelberg: Springer; 2005:81–94.

    Chapter  Google Scholar 

  47. Moore BD III: Neurocognitive outcomes in survivors of childhood cancer. J Pediatr Psychol 2005, 30:51–63.

    Article  PubMed  Google Scholar 

  48. Bassal M, Mertens AC, Taylor L, et al.: Risk of selected subsequent carcinomas in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol 2006, 24:476–483.

    Article  PubMed  Google Scholar 

  49. Bhatia S, Yasui Y, Robison LL, et al.: High risk of subsequent neoplasms continues with extended follow-up of childhood Hodgkin’s disease: report from the Late Effects Study Group. J Clin Oncol 2003, 21:4386–4394.

    Article  PubMed  Google Scholar 

  50. Henderson TO, Whitton J, Stovall M, et al.: Secondary sarcomas in childhood cancer survivors: a report from the Childhood Cancer Survivor Study. J Natl Cancer Inst 2007, 99:300–308.

    Article  PubMed  Google Scholar 

  51. Kenney LB, Yasui Y, Inskip PD, et al.: Breast cancer after childhood cancer: a report from the Childhood Cancer Survivor Study. Ann Intern Med 2004, 141:590–597.

    PubMed  Google Scholar 

  52. Neglia JP, Robison LL, Stovall M, et al.: New primary neoplasms of the central nervous system in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Natl Cancer Inst 2006, 98:1528–1537.

    Article  PubMed  Google Scholar 

  53. Perkins JL, Liu Y, Mitby PA, et al.: Nonmelanoma skin cancer in survivors of childhood and adolescent cancer: a report from the childhood cancer survivor study. J Clin Oncol 2005, 23:3733–3741.

    Article  PubMed  Google Scholar 

  54. Hawkins MM, Wilson LM, Burton HS, et al.: Radiotherapy, alkylating agents, and risk of bone cancer after childhood cancer. J Natl Cancer Inst 1996, 88:270–278.

    Article  PubMed  CAS  Google Scholar 

  55. Swerdlow AJ, Barber JA, Hudson GV, et al.: Risk of second malignancy after Hodgkin’s disease in a collaborative British cohort: the relation to age at treatment. J Clin Oncol 2000, 18:498–509.

    PubMed  CAS  Google Scholar 

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Correspondence to Melissa M. Hudson.

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Nunez, S.B., Mulrooney, D.A., Laverdiere, C. et al. Risk-based health monitoring of childhood cancer survivors: A report from the children’s oncology group. Curr Oncol Rep 9, 440–452 (2007). https://doi.org/10.1007/s11912-007-0062-8

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  • DOI: https://doi.org/10.1007/s11912-007-0062-8

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