Surveillance of hepatic late adverse effects in a large cohort of long-term survivors of childhood cancer: Prevalence and risk factors

Mulder, Renée L.; Kremer, Leontien C. M.; Koot, Bart; Benninga, Marc A.; Knijnenburg, Sebastiaan L.; Pal, Helena J.H. van der; Koning, Caro C.E.; Oldenburger, Foppe; Wilde, James Carl Henri; Taminiau, J. A. J. M.; Caron, Huib N.; Dalen, Elvira C. van

doi:10.1016/j.ejca.2012.07.009

Cited by 25 publications

(27 citation statements)

References 23 publications

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“…Ten of our survivors (28.6 %) have HCV positive antibodies detected by ELISA. These results go with the previous findings of Mulder et al35 who concluded that abnormal high ALT level was detected in survivors of childhood cancer. Also, Schempp et al36 found elevated levels of serum ferritin and soluble transferrin (iron overload) in survivors of childhood cancer and attributed this to Transfusion volume.…”

Section: Discussionsupporting

confidence: 93%

Assessment of obesity and hepatic late adverse effects in the Egyptian survivors of pediatric acute lymphoblastic leukemia: single center study

El-Rashedy¹,

El-Hawy²,

Hefnawy³

et al. 2017

Mediterr J Hematol Infect Dis

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BackgroundChildhood acute lymphoblastic leukemia (ALL) with current cure rates reaching 80% emphasizes the necessity to determine treatment-related long-term effects. The aim of this study is to estimate the prevalence of overweight, obesity, and hepatic late adverse effects in a cohort of ALL survivors treated at the Hematology and Oncology Unit, Pediatrics Department, Menoufia University, Egypt.MethodsIn this case-control study, height, weight, and body mass index (BMI) were assessed for 35 pediatric ALL survivors and 35 healthy children. These parameters were plotted on the growth and WHO standard deviation charts for both males and females. Overweight and obesity were defined by BMI > 85th and 95th percentile respectively. Laboratory investigations were done in the form of iron profile, liver enzymes, total and direct bilirubin levels, serum urea &creatinine and detection of hepatitis C virus antibodies by ELISA.ResultsThe weight and BMI were significantly greater in the survivors than controls (P value =0.002 and 0.039 respectively). ALT, total & direct bilirubin, serum ferritin and transferrin saturation were considerably higher in the survivors than the controls (P value = 0.03, 0.036, 0.044, 0.006 and 0.03 respectively). Ten (28.6%) of survivors had hepatitis C antibodies with none (0%) of controls (P value =0.02)ConclusionsPediatric ALL survivors are at increased risk of overweight/obesity, hepatic dysfunction in the form of elevated liver enzymes, bilirubin levels, and C viral hepatitis. Screening of those survivors for such complications should be considered.

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Section: Discussionsupporting

confidence: 93%

Assessment of obesity and hepatic late adverse effects in the Egyptian survivors of pediatric acute lymphoblastic leukemia: single center study

El-Rashedy¹,

El-Hawy²,

Hefnawy³

et al. 2017

Mediterr J Hematol Infect Dis

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“…With more precise assessment of hepatotoxic chemotherapy and radiation exposures, we have characterized liver injury related to lifestyle factors and medication use in adults followed for more than 20 years after childhood cancer diagnosis. The prevalence of liver injury in our cohort as measured by elevated ALT was 41.3% using sex‐specific values for ULN, and was substantially higher than either 15.2% using our institutional unisex ULN or 5.8% among a younger group of Dutch CCS with shorter follow‐up . ALT elevations were generally low grade in severity, which may be related to progress in pediatric cancer therapeutic strategies and advances in supportive care.…”

Section: Discussionmentioning

confidence: 67%

Serum Alanine Aminotransferase Elevations in Survivors of Childhood Cancer

et al. 2019

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“…We found the highest overall risks for liver disease in survivors treated for hepatic tumour and leukaemia. Whether the risk of hepatic adverse events correlates with the treatment with anthracyclines remains not clear . A systematic review of 20 cohort studies investigating hepatic late adverse effects after antineoplastic treatment for childhood cancer is inconclusive .…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have suggested that the use of methotrexate induces mild structural changes of the liver that may lead to fibrosis/cirrhosis, although it rarely causes end‐stage liver disease . It has been shown that both a high body mass index (BMI) and alcohol intake >14 units per week among survivors correlates with the risk of hepatic complications, similarly to the relationship in the general population . These exposures could partially explain the increased risk of hepatic complications in survivors in our study but we were not able to examine this further due to lack of treatment information and information on lifestyle factors.…”

Section: Discussionmentioning

confidence: 99%

Liver diseases in Adult Life after Childhood Cancer in Scandinavia (ALiCCS): A population‐based cohort study of 32,839 one‐year survivors

Bonnesen

Winther

Andersen

et al. 2017

Intl Journal of Cancer

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Information on late onset liver complications after childhood cancer is scarce. To ensure an appropriate follow-up of childhood cancer survivors and reducing late liver complications, the need for comprehensive and accurate information is presented. We evaluate the risk of liver diseases in a large childhood cancer survivor cohort. We included all 1-year survivors of childhood cancer treated in the five Nordic countries. A Cox proportional hazards model was used to estimate hospitalisation rate (hazard) ratios (HRs) for each liver outcome according to type of cancer. We used the risk among survivors of central nervous system tumour as internal reference. With a median follow-up time of 10 years, 659 (2%) survivors had been hospitalised at least once for a liver disease. The risk for hospitalisation for any liver disease was high after hepatic tumour (HR = 6.9) and leukaemia (HR = 1.7). The Danish sub-cohort of leukaemia treated with haematopoietic stem cell transplantation had a substantially higher risk for hospitalisation for all liver diseases combined (HR = 3.8). Viral hepatitis accounted for 286 of 659 hospitalisations corresponding to 43% of all survivors hospitalised for liver disease. The 20-year cumulative risk of viral hepatitis was 1.8% for survivors diagnosed with cancer before 1990 but only 0.3% for those diagnosed after 1990. The risk of liver disease was low but significantly increased among survivors of hepatic tumours and leukaemia. Further studies with focus on the different treatment modalities are needed to further strengthen the prevention of treatment-induced late liver complications.

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Surveillance of hepatic late adverse effects in a large cohort of long-term survivors of childhood cancer: Prevalence and risk factors

Cited by 25 publications

References 23 publications

Assessment of obesity and hepatic late adverse effects in the Egyptian survivors of pediatric acute lymphoblastic leukemia: single center study

Assessment of obesity and hepatic late adverse effects in the Egyptian survivors of pediatric acute lymphoblastic leukemia: single center study

Serum Alanine Aminotransferase Elevations in Survivors of Childhood Cancer

Liver diseases in Adult Life after Childhood Cancer in Scandinavia (ALiCCS): A population‐based cohort study of 32,839 one‐year survivors

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