Document Detail


Severity of health conditions identified in a pediatric cancer survivor program.
MedLine Citation:
PMID:  20108334     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Common Terminology Criteria for Adverse Events v3.0 (CTCAE) was designed for reporting acute and late effects of cancer treatment. To date, no study of pediatric-aged cancer survivors has graded health conditions using CTCAE, for patients in active follow-up in a cancer survivor program. PROCEDURE: Medical records were reviewed on 519 survivors of non-central nervous system childhood malignancies seen in the Cancer Survivor Program between January 1, 2001 and December 15, 2005. Health problems identified through histories, physicals, and recommended evaluation using the Children's Oncology Group (COG) Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancer were graded using the CTCAE. RESULTS: Overall, 1,625 adverse health conditions were reported or detected in 519 pediatric-age cancer survivors (mean age at diagnosis 4.8 years; mean age at first survivor visit 12.1 years). The majority of conditions were mild (47.4% Grade 1) or moderate (35.2% Grade 2); however, 17.4% of conditions were severe (Grade 3) or life-threatening/disabling (Grade 4). Only 12.1% of survivors had no adverse condition, and 36.2% of survivors had a Grade 3 or 4 condition. In a Cox multivariate analysis risk factors for a Grade 3 or 4 condition included minority race, diagnosis of other malignancy, older age, and a history of a hematopoietic stem cell transplant. CONCLUSIONS: The majority of adverse health conditions in pediatric-aged cancer survivors are mild; however, a significant percentage will have a serious condition. Long-term follow-up with a multidisciplinary approach is essential to detect and intervene in health problems early.
Authors:
Karen Wasilewski-Masker; Ann C Mertens; Briana Patterson; Lillian R Meacham
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  54     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-04-20     Completed Date:  2010-05-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  976-82     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Wiley-Liss, Inc.
Affiliation:
The Aflac Cancer Center and Blood Disorders Service at Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia 30342, USA. karen.wasilewski@choa.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antineoplastic Agents / adverse effects
Child
Child, Preschool
Female
Follow-Up Studies
Guidelines as Topic
Humans
Infant
Male
Neoplasms / complications*,  therapy
Proportional Hazards Models
Quality of Life*
Radiotherapy / adverse effects
Stem Cell Transplantation / adverse effects
Survivors / statistics & numerical data*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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