Health status of young children with cancer following discontinuation of therapy

Abstract

This paper reports late effects and health status of 198 children who had cancer or leukemia diagnosed under 2 years of age and their therapies electively withdrawn. This series (92 neuroblastoma [NBL], 57 Wilms' tumor [WT], 46 acute lymphoblastic leukemia [ALL], and 3 non-Hodgkin's lymphoma) was followed for 1-12 years after discontinuation of therapy. Thirty-three children were diagnosed before 1973, 92 between 1973 and 1977, and 73 after 1977 in 16 Italian Pediatric Oncology Centers. As of December 1983, 176 children were reported to be alive and without evidence of primary cancer by physicians responsible for their care. One child died from a second primary tumor, two from late recurrences of the primary cancer, and three from other causes; eight were alive with evidence of primary cancer; and eight were lost to follow-up. Kyphoscoliosis was found in 22 children and other musculoskeletal anomalies in 8. Neurological sequelae were observed in 8 out 35 children with ALL treated with radiotherapy (RT) and intrathecal methotrexate. All but one were in continuous complete remission when they developed seizures (three cases), leukoencephalopathy (three cases), or intracerebral calcifications (two cases). One child had cardiomyopathy and subsequently died from cardiac failure: he had received doxorubicin (400 mg/m2) and mediastinal RT (13 Gy) for NBL. Growth impairments were observed in children with NBL and WT.

Spinal deformity induced by radiotherapy for solid tumours in childhood: A long-term follow up study

“…Radiographs were not made of all patients in the study of Thomas et al [14], which may be an additional explanation for their smaller incidence. In agreement with this conception Pastore et al [8] also reported that kyphoscoliosis was diagnosed in 44 patients, 40 of whom had received radiotherapy to the spine, among 86 children observed for more than 5 years after diagnosis.…”

“…Tumour invasion and contracture of muscles and soft tissue may also enhance spinal deformities [1,12]. Musculoskeletal sequelae may involve skeletal lesions [8].…”

Marriage and parenthood among childhood cancer survivors: a report from the Italian AIEOP Off-Therapy Registry

“…OTR registration procedures have been described elsewhere. [21][22][23] The OTR is a hospital-based cohort collecting both demographic (gender, place and date of birth, and place of residence at diagnosis) and clinical data. Information on individual patients is periodically updated by the registry coordinating centre in Monza, Northern Italy, with a special focus on events such as relapses, new primary malignancies and vital status.…”

“…[15][16][17][18][19] In Italy, the only attempts to assess the experience of marriage and parenthood of childhood cancer survivors have been carried out in a single region situated in the North-West of the country (representing approximately 7% of the whole Italian population) using data of the Childhood Cancer Registry of Piedmont. 13,20 In the present study, we used data from administrative sources and from the Italian Off-Therapy Registry (OTR), [21][22][23] maintained by the Italian Association of Pediatric Hematology and Oncology (AIEOP), to evaluate the experience of marriage and parenthood in a large cohort of long-term childhood cancer survivors.…”

The comprehensive assessment of health status in survivors of childhood cancer: application to high-risk acute lymphoblastic leukaemia

“…An extensive literature has arisen on the medical costs of cure and the late effects of treatment (Blatt & Bleyer, 1989;Chessells et al, 1981;Green et al, 1991;Lansky et al, 1987; Levine & Hersh, 1982;Links & Stockwell, 1985;Maguire et al, 1987;Meadows et al, 1981Meadows et al, , 1980Mostow et al, 1991;Nesbit et al, 1979;O'Malley et al, 1979;Pastore et al, 1987;Wheeler et al, 1988;Whitt et al, 1984). This literature has identified a wide variety of seqpielae of ALL.…”