Adult Life after Childhood Cancer in Scandinavia: Diabetes mellitus following treatment for cancer in childhood

Holmqvist, Anna Sällfors; Olsen, Jørgen H.; Andersen, Klaus Kaae; Licht, Sofie de Fine; Hjorth, Lars; Garwicz, Stanislaw; Maaser, Christian; Anderson, Harald; Wesenberg, Finn; Tryggvadóttír, Laufey; Malila, Nea; Boice, John D.; Hasle, Henrik; Winther, Jeanette Falck

doi:10.1016/j.ejca.2014.01.014

Cited by 65 publications

(62 citation statements)

References 28 publications

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“…These results are concordant with those from general population studies of pediatric ALL(14, 16, 24) and suggest that the development of or therapy for ALL induces the DM. That only 14/97 ALL patients acquired DM implicates additional genetic and/or environmental susceptibility factors.…”

Section: Discussionsupporting

confidence: 85%

Immune-Related Conditions and Acute Leukemia in Children with Down Syndrome: A Children's Oncology Group Report

Linabery

Roesler

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Children with Down syndrome (DS) have unique immune profiles and increased leukemia susceptibility. Methods Mothers of 158 children with DS diagnosed with acute leukemia at 0-19 years in 1997-2002 and 173 children with DS but no leukemia were interviewed. Associations were evaluated via multivariable unconditional logistic regression. Results No associations were detected for asthma, eczema, allergies, or hypothyroidism. Diabetes mellitus associated with leukemia (odds ratio=9.23, 95% confidence interval: 2.33-36.59), however most instances occurred concurrent with or after the leukemia diagnosis. Conclusions and Impact Children with DS who develop leukemia have increased diabetes risk, likely due to treatment and underlying susceptibility factors.

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Section: Discussionsupporting

confidence: 85%

Immune-Related Conditions and Acute Leukemia in Children with Down Syndrome: A Children's Oncology Group Report

Linabery

Roesler

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…These observations fit to previously published studies from UK where the evaluation of a General Practitioner database revealed a comparably increased risk of osteoporosis and diabetes, particularly in patients with non-Hodgkin disease. Interestingly, despite our expectations that children and adolescents would be more prone to develop late effects, especially of the bone, the frequencies of adult late effects observed in this study appear to be largely similar (5,27,28,29,30,31,32,33). There are a number of potential underlying mechanisms, which due to the nature of the study must remain speculative.…”

Section: Clinical Study J Gebauer E-m Fick and Others Endocrine Latementioning

confidence: 53%

Self-reported endocrine late effects in adults treated for brain tumours, Hodgkin and non-Hodgkin lymphoma: a registry based study in Northern Germany

Gebauer

Fick

Waldmann

et al. 2015

European Journal of Endocrinology

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Objective: Due to the increasing success and survival rates in the primary treatment of malignancies derived from the CNS as well as the hematopoietic system, endocrine late effects of cancer and its therapy are of growing importance. Despite evaluation of these late effects in patients treated for cancer in childhood, the impact on adults remains largely unclear. Methods: 1035 adult patients primarily diagnosed with a CNS malignancy, a Hodgkin (HL) or non-Hodgkin lymphoma (NHL) between 1998 and 2008 were recruited via the regional epidemiological cancer registry covering w2.8 million inhabitants in the federal state of Schleswig-Holstein, Northern Germany. The prevalence of endocrine disorders and current psychosocial impairment was assessed employing several questionnaires (SF-36v1, WHO-5). Results: Fully completed questionnaires of 558 patients were available for subsequent analysis showing markedly reduced overall performance and psychological status when compared to German reference data. Thyroid disorders were reported in 16.3% of patients with 10.4% suffering from hypo-and 5.9% from hyperthyroidism. Overall, 17.6% stated to be affected by diabetes mellitus with an increased rate of 21.1% among NHL patients and 11.5% of participants were affected by osteoporosis. Conclusion: Compared to German population based studies on the prevalence of diabetes mellitus, osteoporosis and thyroid disorders the frequency of all these endocrine problems was significantly increased in CNS, HL, and NHL cancer survivors. These data confirm that not only children and adolescents but also adult cancer patients are at risk for therapy associated endocrine late effects.

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“…28 In a previous population-based register study, the Nordic childhood cancer survivors were 1.8 times more likely than the sibling comparison group to report diabetes mellitus. 29 The majority of these survivors were treated with conventional protocols without HSCT. Particularly TBI has been identified as a risk factor for the metabolic syndrome after HSCT.…”

Section: Discussionmentioning

confidence: 99%

Adverse health events and late mortality after pediatric allogeneic hematopoietic SCT—two decades of longitudinal follow-up

Wilhelmsson

Vatanen

Borgström

et al. 2015

Bone Marrow Transplant

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Treatment-related late toxicities after pediatric allogeneic hematopoietic SCT (allo-HSCT) are increasingly important as long-term survival has become an expected outcome for many transplanted children and adolescents. In a retrospective cohort study, we assessed long-term health outcomes in 204 allo-HSCT survivors transplanted in childhood or adolescence (o 20 years) between 1978 through 2000 after a median follow-up time of 12 (range 4-28) years. Data on conditioning regimen, adverse health events (AE) and growth and hormonal substitutions (hormone replacement therapies (HRTs)) were obtained from medical records. AEs were graded retrospectively according to Common Terminology Criteria for Adverse Events v3.0. Late deaths (⩾48 months after allo-HSCT) were evaluated separately. Multivariate analysis demonstrated that chronic GVHD (P o0.000) and longer follow-up time (P o0.05) correlated with AEs, whereas CY-based conditioning was inversely correlated (P o 0.002). TBI and longer follow-up duration predicted more severe AEs (P o 0.001 and P o 0.001, respectively). HRTs were more frequent after TBI. Diabetes type II, dyslipidemia and hypertension were detected in 9, 7 and 7% of the survivors, respectively. Late deaths (n = 22) were most frequently due to pulmonary failure (n = 7), followed by secondary malignancy (n = 5). The occurrence of AEs after pediatric allo-HSCT is high and likely to increase during extended follow-up, particularly in patients who have received TBI.

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Adult Life after Childhood Cancer in Scandinavia: Diabetes mellitus following treatment for cancer in childhood

Cited by 65 publications

References 28 publications

Immune-Related Conditions and Acute Leukemia in Children with Down Syndrome: A Children's Oncology Group Report

Immune-Related Conditions and Acute Leukemia in Children with Down Syndrome: A Children's Oncology Group Report

Self-reported endocrine late effects in adults treated for brain tumours, Hodgkin and non-Hodgkin lymphoma: a registry based study in Northern Germany

Adverse health events and late mortality after pediatric allogeneic hematopoietic SCT—two decades of longitudinal follow-up

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