Long term effects of therapy among childhood cancer survivors treated in the last two decades

AbdelHameid, Duaa; Mills, Alissa; Dean, Jennifer B.; Piguet, Niccole B.; Shankar, Sadhna

doi:10.1016/j.phoj.2019.03.002

Cited by 2 publications

(5 citation statements)

References 15 publications

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“…In a study that included 129 childhood cancer survivors treated by the 1990s treatment protocols, additional school resources were needed by 30% of the survivors, from which 50% were pediatric ALL survivors mostly treated with chemotherapy alone. In the same study, 10% of participants required attention deficit hyperactivity disorder (ADHD) prescription medication, double the national average of children between 2-17 years of age (68). Other studies reported an increased cumulative dose of intravenous methotrexate (doses more than 4.3mg/m2) is associated with an increased risk of inattention-hyperactivity (116).…”

Section: Neurocognitive Effectsmentioning

confidence: 91%

“…Avascular bone necrosis is a common corticosteroids complication. Fractures are reported in 64% of pediatric ALL patients, which is the highest rate in comparison to other childhood cancer types (68).…”

Section: Corticosteroids-induced Bone Toxicitymentioning

confidence: 96%

“…Older regimens used a combination of CRT and intrathecal methotrexate as CNS prophylaxis. However, CRT intensity has been reduced, and then it was omitted for most ALL patients after recognizing its detrimental effects on intellectual and learning capabilities (68,113).…”

Section: Neurocognitive Effectsmentioning

confidence: 99%

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Long-Term Effects of Pediatric Acute Lymphoblastic Leukemia Chemotherapy: Can Recent Findings Inform Old Strategies?

2021

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During the last few decades, pediatric acute lymphoblastic leukemia (ALL) cure rates have improved significantly with rates exceeding 90%. Parallel to this remarkable improvement, there has been mounting interest in the long-term health of the survivors. Consequently, modified treatment protocols have been developed and resulted in the reduction of many adverse long-term consequences. Nevertheless, these are still substantial concerns that warrant further mitigation efforts. In the current review, pediatric-ALL survivors’ late adverse events, including secondary malignant neoplasms (SMNs), cardiac toxicity, neurotoxicity, bone toxicity, hepatic dysfunction, visual changes, obesity, impact on fertility, and neurocognitive effects have been evaluated. Throughout this review, we attempted to answer a fundamental question: can the recent molecular findings mitigate pediatric-ALL chemotherapy’s long-term sequelae on adult survivors? For SMNs, few genetic predisposition factors have been identified including TP53 and POT1 variants. Other treatment-related risk factors have been identified such as anthracyclines’ possible association with breast cancer in female survivors. Cardiotoxicity is another significant and common adverse event with some germline variants been found, albeit with conflicting evidence, to increase the risk of cardiac toxicity. For peripheral neurotoxicity, vincristine is the primary neurotoxic agent in ALL regimens. Some germline genetic variants were found to be associated with the vincristine neurotoxic effect’s vulnerability. However, these were mainly detected with acute neuropathy. Moreover, the high steroid doses and prolonged use increase bone toxicity and obesity risk with some pharmacogenetic biomarkers were associated with increased steroid sensitivity. Therefore, the role of these biomarkers in tailoring steroid choice and dose is a promising research area. Future directions in pediatric ALL treatment should consider the various opportunities provided by genomic medicine. Understanding the molecular bases underlying toxicities will classify patients into risk groups and implement a closer follow-up to those at higher risk. Pharmacogenetic-guided dosing and selecting between alternative agents have proven their efficacy in the short-term management of childhood ALL. It is the right time to think about a similar approach for the life-long consequences on survivors.

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Section: Neurocognitive Effectsmentioning

confidence: 91%

Section: Corticosteroids-induced Bone Toxicitymentioning

confidence: 96%

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Long-Term Effects of Pediatric Acute Lymphoblastic Leukemia Chemotherapy: Can Recent Findings Inform Old Strategies?

2021

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“…Son beş yıldır hayatta kalma oranı bazı yüksek gelirli ülkelerde AML için %70'i aşıyor ancak bazı hepatik ve merkezi sinir sistemi tümörleri için hala %60'ın altında (2). Çocukluk çağı kanserinden sağkalımda iyileşme, hayatta kalanlar arasında artmış uzun vadeli komplikasyon oranı ve kansere bağlı olmayan ölüm riskinde artış ile ilişkilendirilmiştir (4).…”

Section: 4çocukluk çAğı Kanserinde Hayatta Kalmaunclassified

“…Aynı zamanda ülkelerin sosyoekonomik durumu gelişmişlik düzeylerine göre de ülkeler arasındaki hayatta kalma oranları değişiklik göstermektedir. Çocukluk çağı kanserinden kurtulanların sonrasında kanser tedavisi nedeniyle çeşitli somatik ve zihinsel sağlık sorunlarının yanı sıra olumsuz sosyal ve sosyoekonomik sonuçlara, psikolojik sorunlara sebep olabileceği gözlemlenmiştir (2,4). Çocukluk çağı kanserinin nedenleri son on yıllarda sistematik olarak incelenmektedir.…”

Section: Introductionunclassified

Çocukluk Çağı Kanseri

ARSLAN

Ipek

2022

Haliç Üniversitesi Sağlık Bilimleri Dergisi

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Cancer is a disease characterized by uncontrolled cell proliferation manifested by tumor formation, which is a physiological disorder. Childhood cancer is the leading cause of death in children. Following the World Health Organization's emphasis on child health, most governments around the world have taken measures to facilitate childhood cancer research. With the advent of multimodality therapy, it is seen that the death rate from cancer has decreased in the last five years, and today, cancer survival has exceeded 80% in most European and North American countries. Significant advances in survival have led to an ever-increasing population of childhood cancer survivors. Childhood cancer survivors are at risk for various serious physical and mental health conditions attributable to cancer and its treatment, as well as adverse social and socioeconomic consequences and reduced psychological well-being and quality of life. Early diagnosis is important in children because there are no screening tests like in adults And it is a very important task to be careful with, for the physicians who follow the child. Studies prove the idea that reduction in daily physical activity is the primary cause of chronic diseases/conditions and that physical activity/exercise is the rehabilitation treatment (therapy) of dysfunctional dysfunctions caused by inactivity. The aim of this review is to examine general information about childhood cancer and the effects of physical activity.

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Long term effects of therapy among childhood cancer survivors treated in the last two decades

Cited by 2 publications

References 15 publications

Long-Term Effects of Pediatric Acute Lymphoblastic Leukemia Chemotherapy: Can Recent Findings Inform Old Strategies?

Long-Term Effects of Pediatric Acute Lymphoblastic Leukemia Chemotherapy: Can Recent Findings Inform Old Strategies?

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