The Experts below are selected from a list of 33921 Experts worldwide ranked by ideXlab platform
Wendy M Leisenring - One of the best experts on this subject based on the ideXlab platform.
-
assisted reproductive technology outcomes in Childhood Cancer survivors a report from the Childhood Cancer survivor study
Journal of Clinical Oncology, 2020Co-Authors: Kimberly W Keefe, Andrea Lanes, Kayla Stratton, Daniel M Green, Eric J Chow, Kevin C Oeffinger, Sara E Barton, Lisa Diller, Yutaka Yasui, Wendy M LeisenringAbstract:10528Background: Some treatment exposures for Childhood Cancer reduce ovarian reserve. Registry-based evaluation has not been conducted for assisted reproductive technology (ART) outcomes of female...
-
long term risk of venous thromboembolism in survivors of Childhood Cancer a report from the Childhood Cancer survivor study
Journal of Clinical Oncology, 2018Co-Authors: Yutaka Yasui, Wendy M Leisenring, Todd M. Gibson, Qi Liu, Arin L Madenci, Brent R Weil, Andrew J Murphy, Rebecca M Howell, Christopher L TinkleAbstract:PurposeTo estimate the incidence of late-occurring venous thromboembolism (VTE) among survivors of Childhood Cancer and to identify risk factors for VTE to facilitate diagnosis and prevention.MethodsThe Childhood Cancer Survivor Study is a multi-institutional cohort of 24,355 5-year Childhood Cancer survivors (diagnosed between 1970 and 1999; median age at last follow-up, 28.7 years [range, 5.6 to 58.9 years]; median follow-up since diagnosis, 21.3 years [range, 5.0 to 39.2 years]) and 5,051 sibling participants. The primary end point was self-reported late (≥ 5 years after Cancer diagnosis) VTE. Rate ratios (RRs) were estimated with multivariable piecewise exponential models.ResultsLate VTE incidence among survivors and siblings was 1.1 and 0.5 events per 1,000 person-years, respectively (RR, 2.2; 95% CI, 1.7 to 2.8), with 2.5 excess events per 100 survivors over 35 years. Among survivors, risk factors for VTE were female sex (RR, 1.3; 95% CI, 1.1 to 1.6), cisplatin (reference none; 1 to 199 mg/m2: RR, 3...
-
Hypothyroidism after Radiation Therapy for Childhood Cancer: A Report from the Childhood Cancer Survivor Study.
Radiation research, 2018Co-Authors: Peter D. Inskip, Eric J Chow, Marilyn Stovall, Lene H.s. Veiga, Alina V. Brenner, Alice J. Sigurdson, Evgenia Ostroumova, Susan A. Smith, Rita E. Weathers, Wendy M LeisenringAbstract:While thyroid Cancer risks from exposure to ionizing radiation early in life are well characterized quantitatively, the association of radiation with nonmalignant, functional thyroid disorders has been less studied. Here, we report on a risk analysis study of hypothyroidism with radiation dose to the thyroid gland and the hypothalamic-pituitary axis among survivors of Childhood Cancer. Utilizing data from the Childhood Cancer Survivor Study, a cohort of 14,364 five-year survivors of Childhood Cancer diagnosed at 26 hospitals in the U.S. and Canada between 1970 and 1986 and followed through 2009, the occurrence of hypothyroidism was ascertained among 12,015 survivors through serial questionnaires. Radiation doses to the thyroid gland and pituitary gland were estimated from radiotherapy records. Binary outcome regression was used to estimate prevalence odds ratios for hypothyroidism at five years from diagnosis of Childhood Cancer and Poisson regression to model incidence rate ratios (RR) after the first fi...
-
Solid organ transplant after treatment for Childhood Cancer: A report from the Childhood Cancer Survivor Study.
Journal of Clinical Oncology, 2017Co-Authors: Andrew C. Dietz, Daniel M Green, Lisa Diller, Wendy M Leisenring, Kristy Seidel, Daniel A. Mulrooney, Jean M. Tersak, Richard D. Glick, Cathy A. Burnweit, Kevin C OeffingerAbstract:10559Background: Childhood Cancer therapy is associated with late onset, organ-specific impairment. However, the prevalence of and outcomes after solid organ transplant (SOT) in Childhood Cancer su...
-
Endocrine Abnormalities in Aging Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016Co-Authors: Sogol Mostoufi-moab, Daniel M Green, Kevin C Oeffinger, Wendy M Leisenring, Gregory T. Armstrong, Kristy Seidel, Marilyn Stovall, Rita E. Weathers, Lillian R. Meacham, Jill P. GinsbergAbstract:PurposeThe development of endocrinopathies in survivors of Childhood Cancer as they age remains understudied. We characterized endocrine outcomes in aging survivors from the Childhood Cancer Survivor Study on the basis of therapeutic exposures.Patients and MethodsWe analyzed self-reported conditions in 14,290 5-year survivors from the Childhood Cancer Survivor Study, with a median age 6 years (range, < 1 to 20 years) at diagnosis and 32 years (range, 5 to 58 years) at last follow-up. Identification of high-risk therapeutic exposures was adopted from the Children’s Oncology Group Long-Term Follow-Up Guidelines. Cumulative incidence curves and prevalence estimates quantified and regression models compared risks of primary hypothyroidism, hyperthyroidism, thyroid neoplasms, hypopituitarism, obesity, diabetes mellitus, or gonadal dysfunction between survivors and siblings.ResultsThe cumulative incidence and prevalence of endocrine abnormalities increased across the lifespan of survivors (P < .01 for all). Ris...
Leslie L. Robison - One of the best experts on this subject based on the ideXlab platform.
-
Financial Burden in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017Co-Authors: Ryan D. Nipp, Anne C. Kirchhoff, Douglas Fair, Julia Rabin, Kelly A. Hyland, Karen Kuhlthau, Giselle K. Perez, Leslie L. Robison, Gregory T. Armstrong, Paul C. NathanAbstract:Purpose Survivors of Childhood Cancer may experience financial burden as a result of health care costs, particularly because these patients often require long-term medical care. We sought to evaluate the prevalence of financial burden and identify associations between a higher percentage of income spent on out-of-pocket medical costs (≥ 10% of annual income) and issues related to financial burden (jeopardizing care or changing lifestyle) among survivors of Childhood Cancer and a sibling comparison group. Methods Between May 2011 and April 2012, we surveyed an age-stratified, random sample of survivors of Childhood Cancer and a sibling comparison group who were enrolled in the Childhood Cancer Survivor Study. Participants reported their household income, out-of-pocket medical costs, and issues related to financial burden (questions were adapted from national surveys on financial burden). Logistic regression identified associations between participant characteristics, a higher percentage of income spent on out-of-pocket medical costs, and financial burden, adjusting for potential confounders. Results Among 580 survivors of Childhood Cancer and 173 siblings, survivors of Childhood Cancer were more likely to have out-of-pocket medical costs ≥ 10% of annual income (10.0% v 2.9%; P < .001). Characteristics of the survivors of Childhood Cancer that were associated with a higher percentage of income spent on out-of-pocket costs included hospitalization in the past year (odds ratio [OR], 2.3; 95% CI, 1.1 to 4.9) and household income < $50,000 (OR, 5.5; 95% CI, 2.4 to 12.8). Among survivors of Childhood Cancer, a higher percentage of income spent on out-of-pocket medical costs was significantly associated with problems paying medical bills (OR, 8.9; 95% CI, 4.4 to 18.0); deferring care for a medical problem (OR, 3.0; 95% CI, 1.6 to 5.9); skipping a test, treatment, or follow-up (OR, 2.1; 95% CI, 1.1 to 4.0); and thoughts of filing for bankruptcy (OR, 6.6; 95% CI, 3.0 to 14.3). Conclusion Survivors of Childhood Cancer are more likely to report spending a higher percentage of their income on out-of-pocket medical costs, which may influence their health-seeking behavior and potentially affect health outcomes. Our findings highlight the need to address financial burden in this population with long-term health care needs.
-
telomere content and risk of second malignant neoplasm in survivors of Childhood Cancer a report from the Childhood Cancer survivor study
Clinical Cancer Research, 2014Co-Authors: Maria M. Gramatges, Yutaka Yasui, Leslie L. Robison, Gregory T. Armstrong, Louise C. Strong, Joseph P. Neglia, Fatih M Okcu, Smita BhatiaAbstract:Purpose: Shorter constitutional telomere length has been associated with increased Cancer incidence. Furthermore, telomere shortening is observed in response to intensive chemotherapy and/or ionizing radiation exposure. We aimed to determine whether less telomere content was associated with treatment-related second malignant neoplasms (SMN) in Childhood Cancer survivors. Experimental Design: Using a nested case–control design, 147 Cancer survivors with breast Cancer, thyroid Cancer, or sarcoma developing after treatment for Childhood Cancer (cases) were matched (1:1) with Childhood Cancer survivors without a SMN (controls). Cases and controls were matched by primary Cancer diagnosis, years since diagnosis, age at the time of sample collection, years of follow-up from Childhood Cancer diagnosis, exposure to specific chemotherapy agents, and to specific radiation fields. We performed conditional logistic regression using telomere content as a continuous variable to estimate ORs with corresponding 95% confidence intervals (CI) for development of SMN. ORs were also estimated for specific SMN types, i.e., breast Cancer, thyroid Cancer, and sarcoma. Results: There was an inverse relationship between telomere content and SMN, with an adjusted OR of 0.3 per unit change in telomere length to single-copy gene ratio (95% CI, 0.09–1.02; P = 0.05). Patients with thyroid Cancer SMN were less likely to have more telomere content (OR, 0.04; 95% CI, 0.00–0.55; P = 0.01), but statistically significant associations could not be demonstrated for breast Cancer or sarcoma. Conclusions: A relation between less telomere content and treatment-related thyroid Cancer was observed, suggesting that shorter telomeres may contribute to certain SMNs in Childhood Cancer survivors. Clin Cancer Res; 20(4); 904–11. ©2013 AACR .
-
TelomereContentandRiskofSecondMalignantNeoplasmin Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study
2014Co-Authors: Maria M. Gramatges, Yutaka Yasui, Leslie L. Robison, Gregory T. Armstrong, Louise C. Strong, Joseph P. Neglia, Qi Liu, M. Fatih Okcu, Smita BhatiaAbstract:Purpose: Shorter constitutional telomere length has been associated with increased Cancer incidence. Furthermore, telomere shortening is observed in response to intensive chemotherapy and/or ionizing radiation exposure. We aimed to determine whether less telomere content was associated with treatmentrelated second malignant neoplasms (SMN) in Childhood Cancer survivors. Experimental Design: Using a nested case–control design, 147 Cancer survivors with breast Cancer, thyroidCancer,orsarcomadevelopingaftertreatmentforChildhoodCancer(cases)werematched(1:1)with Childhood Cancer survivors without a SMN (controls). Cases and controls were matched by primary Cancer diagnosis, years since diagnosis, age at the time of sample collection, years of follow-up from Childhood Cancer diagnosis, exposure to specific chemotherapy agents, and to specific radiation fields. We performed conditional logistic regression using telomere content as a continuous variable to estimate ORs with corresponding95%confidence intervals(CI) fordevelopment ofSMN.ORswere alsoestimated forspecific SMN types, i.e., breast Cancer, thyroid Cancer, and sarcoma. Results: There was an inverse relationship between telomere content and SMN, with an adjusted OR of 0.3perunitchangeintelomerelengthtosingle-copygeneratio(95%CI,0.09–1.02;P ¼0.05).Patientswith thyroidCancerSMNwerelesslikelytohavemoretelomerecontent(OR,0.04;95%CI,0.00–0.55;P ¼0.01), but statistically significant associations could not be demonstrated for breast Cancer or sarcoma. Conclusions: A relation between less telomere content and treatment-related thyroid Cancer was observed, suggesting that shorter telomeres may contribute to certain SMNs in Childhood Cancer survivors. Clin Cancer Res; 20(4); 904–11. � 2013 AACR.
-
Psychoactive medication use and neurocognitive function in adult survivors of Childhood Cancer: a report from the Childhood Cancer Survivor study.
Pediatric blood & cancer, 2012Co-Authors: Tara M. Brinkman, Daniel M Green, Leslie L. Robison, Marilyn Stovall, Deokumar Srivastava, Lonnie K. Zeltzer, Nancy R. Zhang, Nicole J. Ullrich, Pim Brouwers, Kevin R. KrullAbstract:Background Adult survivors of Childhood Cancer are at risk for long-term morbidities, which may be managed pharmacologically. Psychoactive medication treatment has been associated with adverse effects on specific neurocognitive processes in non-Cancer populations, yet these associations have not been examined in adult survivors of Childhood Cancer.
-
long term effects of radiation exposure among adult survivors of Childhood Cancer results from the Childhood Cancer survivor study
Radiation Research, 2010Co-Authors: Gregory T. Armstrong, Marilyn Stovall, Leslie L. RobisonAbstract:Abstract In the last four decades, advances in therapies for primary Cancers have improved overall survival for Childhood Cancer. Currently, almost 80% of children will survive beyond 5 years from diagnosis of their primary malignancy. These improved outcomes have resulted in a growing population of Childhood Cancer survivors. Radiation therapy, while an essential component of primary treatment for many Childhood malignancies, has been associated with risk of long-term adverse outcomes. The Childhood Cancer Survivor Study (CCSS), a retrospective cohort of over 14,000 survivors of Childhood Cancer diagnosed between 1970 and 1986, has been an important resource to quantify associations between radiation therapy and risk of long-term adverse health and quality of life outcomes. Radiation therapy has been associated with increased risk for late mortality, development of second neoplasms, obesity, and pulmonary, cardiac and thyroid dysfunction as well as an increased overall risk for chronic health conditions....
Marilyn Stovall - One of the best experts on this subject based on the ideXlab platform.
-
Hypothyroidism after Radiation Therapy for Childhood Cancer: A Report from the Childhood Cancer Survivor Study.
Radiation research, 2018Co-Authors: Peter D. Inskip, Eric J Chow, Marilyn Stovall, Lene H.s. Veiga, Alina V. Brenner, Alice J. Sigurdson, Evgenia Ostroumova, Susan A. Smith, Rita E. Weathers, Wendy M LeisenringAbstract:While thyroid Cancer risks from exposure to ionizing radiation early in life are well characterized quantitatively, the association of radiation with nonmalignant, functional thyroid disorders has been less studied. Here, we report on a risk analysis study of hypothyroidism with radiation dose to the thyroid gland and the hypothalamic-pituitary axis among survivors of Childhood Cancer. Utilizing data from the Childhood Cancer Survivor Study, a cohort of 14,364 five-year survivors of Childhood Cancer diagnosed at 26 hospitals in the U.S. and Canada between 1970 and 1986 and followed through 2009, the occurrence of hypothyroidism was ascertained among 12,015 survivors through serial questionnaires. Radiation doses to the thyroid gland and pituitary gland were estimated from radiotherapy records. Binary outcome regression was used to estimate prevalence odds ratios for hypothyroidism at five years from diagnosis of Childhood Cancer and Poisson regression to model incidence rate ratios (RR) after the first fi...
-
Endocrine Abnormalities in Aging Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016Co-Authors: Sogol Mostoufi-moab, Daniel M Green, Kevin C Oeffinger, Wendy M Leisenring, Gregory T. Armstrong, Kristy Seidel, Marilyn Stovall, Rita E. Weathers, Lillian R. Meacham, Jill P. GinsbergAbstract:PurposeThe development of endocrinopathies in survivors of Childhood Cancer as they age remains understudied. We characterized endocrine outcomes in aging survivors from the Childhood Cancer Survivor Study on the basis of therapeutic exposures.Patients and MethodsWe analyzed self-reported conditions in 14,290 5-year survivors from the Childhood Cancer Survivor Study, with a median age 6 years (range, < 1 to 20 years) at diagnosis and 32 years (range, 5 to 58 years) at last follow-up. Identification of high-risk therapeutic exposures was adopted from the Children’s Oncology Group Long-Term Follow-Up Guidelines. Cumulative incidence curves and prevalence estimates quantified and regression models compared risks of primary hypothyroidism, hyperthyroidism, thyroid neoplasms, hypopituitarism, obesity, diabetes mellitus, or gonadal dysfunction between survivors and siblings.ResultsThe cumulative incidence and prevalence of endocrine abnormalities increased across the lifespan of survivors (P < .01 for all). Ris...
-
breast Cancer after chest radiation therapy for Childhood Cancer
Journal of Clinical Oncology, 2014Co-Authors: Chaya S Moskowitz, Wendy M Leisenring, Marilyn Stovall, Danielle Novetsky Friedman, Joanne F Chou, Suzanne L Wolden, Jonine L Bernstein, Jyoti Malhotra, Nidha Z Mubdi, Sue HammondAbstract:Purpose The risk of breast Cancer is high in women treated for a Childhood Cancer with chest irradiation. We sought to examine variations in risk resulting from irradiation field and radiation dose. Patients and Methods We evaluated cumulative breast Cancer risk in 1,230 female Childhood Cancer survivors treated with chest irradiation who were participants in the CCSS (Childhood Cancer Survivor Study). Results Childhood Cancer survivors treated with lower delivered doses of radiation (median, 14 Gy; range, 2 to 20 Gy) to a large volume (whole-lung field) had a high risk of breast Cancer (standardized incidence ratio [SIR], 43.6; 95% CI, 27.2 to 70.3), as did survivors treated with high doses of delivered radiation (median, 40 Gy) to the mantle field (SIR, 24.2; 95% CI, 20.7 to 28.3). The cumulative incidence of breast Cancer by age 50 years was 30% (95% CI, 25 to 34), with a 35% incidence among Hodgkin lymphoma survivors (95% CI, 29 to 40). Breast Cancer‐specific mortality at 5 and 10 years was 12% (95% CI, 8 to 18) and 19% (95% CI, 13 to 25), respectively. Conclusion Among women treated for Childhood Cancer with chest radiation therapy, those treated with whole-lung irradiation have a greater risk of breast Cancer than previously recognized, demonstrating the importance of radiation volume. Importantly, mortality associated with breast Cancer after Childhood Cancer is substantial.
-
Melanoma as a subsequent neoplasm in adult survivors of Childhood Cancer: A report from the Childhood Cancer survivor study†‡
Pediatric blood & cancer, 2012Co-Authors: Alberto S. Pappo, Wendy M Leisenring, Gregory T. Armstrong, Marilyn Stovall, Sue Hammond, Joseph P. Neglia, Wei Liu, Deokumar Srivastava, Aaron Mcdonald, L. L. RobisonAbstract:Background Childhood Cancer survivors have a six fold increased risk of developing subsequent neoplasms when compared to the general population. We sought to describe the occurrence of melanoma as a subsequent neoplasm among adult survivors of Childhood Cancer.
-
Psychoactive medication use and neurocognitive function in adult survivors of Childhood Cancer: a report from the Childhood Cancer Survivor study.
Pediatric blood & cancer, 2012Co-Authors: Tara M. Brinkman, Daniel M Green, Leslie L. Robison, Marilyn Stovall, Deokumar Srivastava, Lonnie K. Zeltzer, Nancy R. Zhang, Nicole J. Ullrich, Pim Brouwers, Kevin R. KrullAbstract:Background Adult survivors of Childhood Cancer are at risk for long-term morbidities, which may be managed pharmacologically. Psychoactive medication treatment has been associated with adverse effects on specific neurocognitive processes in non-Cancer populations, yet these associations have not been examined in adult survivors of Childhood Cancer.
Ann C. Mertens - One of the best experts on this subject based on the ideXlab platform.
-
subsequent neoplasms in 5 year survivors of Childhood Cancer the Childhood Cancer survivor study
Journal of the National Cancer Institute, 2010Co-Authors: Debra L. Friedman, Wendy M Leisenring, John Whitton, Marilyn Stovall, Ann C. Mertens, Sue Hammond, Anna T. Meadows, Sarah S Donaldson, Leslie L. RobisonAbstract:Background The occurrence of subsequent neoplasms has direct impact on the quantity and quality of life in Cancer survivors. We have expanded our analysis of these events in the Childhood Cancer Survivor Study (CCSS) to better understand the occurrence of these events as the survivor population ages. Methods The incidence of and risk for subsequent neoplasms occurring 5 years or more after the Childhood Cancer diagnosis were determined among 14 359 5-year survivors in the CCSS who were treated from 1970 through 1986 and who were at a median age of 30 years (range = 5–56 years) for this analysis. At 30 years after Childhood Cancer diagnosis, we calculated cumulative incidence at 30 years of subsequent neoplasms and calculated standardized incidence ratios (SIRs), excess absolute risks (EARs) for invasive second malignant neoplasms, and relative risks for subsequent neoplasms by use of multivariable Poisson regression. Results Among 14 359 5-year survivors, 1402 subsequently developed 2703 neoplasms. Cumulative incidence at 30 years after the Childhood Cancer diagnosis was 20.5% (95% confidence interval [CI] = 19.1% to 21.8%) for all subsequent neoplasms, 7.9% (95% CI = 7.2% to 8.5%) for second malignant neoplasms (excluding nonmelanoma skin Cancer), 9.1% (95% CI = 8.1% to 10.1%) for nonmelanoma skin Cancer, and 3.1% (95% CI = 2.5% to 3.8%) for meningioma. Excess risk was evident for all primary diagnoses (EAR = 2.6 per 1000 person-years, 95% CI = 2.4 to 2.9 per 1000 person-years; SIR = 6.0, 95% CI = 5.5 to 6.4), with the highest being for Hodgkin lymphoma (SIR = 8.7, 95% CI = 7.7 to 9.8) and Ewing sarcoma (SIR = 8.5, 95% CI = 6.2 to 11.7). In the Poisson multivariable analysis, female sex, older age at diagnosis, earlier treatment era, diagnosis of Hodgkin lymphoma, and treatment with radiation therapy were associated with increased risk of subsequent neoplasm. Conclusions As Childhood Cancer survivors progress through adulthood, risk of subsequent neoplasms increases. Patients surviving Hodgkin lymphoma are at greatest risk. There is no evidence of risk reduction with increasing duration of follow-up.
-
second neoplasms in survivors of Childhood Cancer findings from the Childhood Cancer survivor study cohort
Journal of Clinical Oncology, 2009Co-Authors: Anna T. Meadows, Yutaka Yasui, Marilyn Stovall, Ann C. Mertens, Debra L. Friedman, Sue Hammond, Joseph P. Neglia, Sarah S Donaldson, Peter D. InskipAbstract:PURPOSE: To review the reports of subsequent neoplasms (SNs) in the Childhood Cancer Survivor Study (CCSS) cohort that were made through January 1, 2006, and published before July 31, 2008, and to discuss the host-, disease-, and therapy-related risk factors associated with SNs. PATIENTS AND METHODS: SNs were ascertained by survivor self-reports and subsequently confirmed by pathology findings or medical record review. Cumulative incidence of SNs and standardized incidence ratios for second malignant neoplasms (SMNs) were calculated. The impact of host-, disease-, and therapy-related risk factors was evaluated by Poisson regression. RESULTS: Among 14,358 cohort members, 730 reported 802 SMNs (excluding nonmelanoma skin Cancers). This represents a 2.3-fold increase in the number of SMNs over that reported in the first comprehensive analysis of SMNs in the CCSS cohort, which was done 7 years ago. In addition, 66 cases of meningioma and 1,007 cases of nonmelanoma skin Cancer were diagnosed. The 30-year cumulative incidence of SMNs was 9.3% and that of nonmelanoma skin Cancer was 6.9%. Risk of SNs remains elevated for more than 20 years of follow-up for all primary Childhood Cancer diagnoses. In multivariate analyses, risks differ by SN subtype, but include radiotherapy, age at diagnosis, sex, family history of Cancer, and primary Childhood Cancer diagnosis. Female survivors whose primary Childhood Cancer diagnosis was Hodgkin's lymphoma or sarcoma and who received radiotherapy are at particularly increased risk. Analyses of risk associated with radiotherapy demonstrated different dose-response curves for specific SNs. CONCLUSION: Childhood Cancer survivors are at a substantial and increasing risk for SNs, including nonmelanoma skin Cancer and meningiomas. Health care professionals should understand the magnitude of these risks to provide individuals with appropriate counseling and follow-up.
-
medical care in long term survivors of Childhood Cancer a report from the Childhood Cancer survivor study
Journal of Clinical Oncology, 2008Co-Authors: Paul C. Nathan, Wendy M Leisenring, Ann C. Mertens, Kirsten K. Ness, Sarah S Donaldson, Mark L Greenberg, Melissa M Hudson, Martin C Mahoney, James G Gurney, Leslie L. RobisonAbstract:Purpose To evaluate whether Childhood Cancer survivors receive regular medical care focused on the specific morbidities that can arise from their therapy. Patients and Methods We conducted a cross-sectional survey of health care use in 8,522 participants in the Childhood Cancer Survivor Study, a multi-institutional cohort of Childhood Cancer survivors. We assessed medical visits in the preceding 2 years, whether these visits were related to the prior Cancer, whether survivors received advice about how to reduce their long-term risks, and whether screening tests were discussed or ordered. Completion of echocardiograms and mammograms were assessed in patients at high risk for cardiomyopathy or breast Cancer. We examined the relationship between demographics, treatment, health status, chronic medical conditions, and health care use. Results
-
Behavioral and Social Outcomes in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2007Co-Authors: Kris Ann P. Schultz, Leslie L. Robison, John Whitton, Kirsten K. Ness, Christopher J. Recklitis, Brad Zebrack, Lonnie K. Zeltzer, Ann C. MertensAbstract:Purpose Adolescents, regardless of medical history, may face behavioral and social challenges. Cancer and related treatments represent additional challenges for teens navigating the transition from Childhood to adulthood. This study was conducted to evaluate behavioral and social outcomes of adolescent Childhood Cancer survivors using data from the Childhood Cancer Survivor Study.
-
Secondary Sarcomas in Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study
Journal of the National Cancer Institute, 2007Co-Authors: Tara O. Henderson, John Whitton, Marilyn Stovall, Ann C. Mertens, Pauline Mitby, Debra L. Friedman, Louise C. Strong, Sue Hammond, Joseph P. Neglia, Anna T. MeadowsAbstract:Background Childhood Cancer survivors are at increased risk for the development of secondary sarcomas. Exposure to radiation therapy is a known risk factor for the development of these sarcomas. Other risk factors for secondary sarcomas have not been well described for Childhood Cancer survivors. We analyzed a large cohort of Childhood Cancer survivors to determine the true incidence of secondary sarcomas and to examine factors associated with the risk of developing secondary sarcomas. Methods The history of secondary sarcomas in 14 372 participants in the Childhood Cancer Survivor Study was determined from self-reports in three questionnaires. Risk of secondary sarcoma was evaluated by use of standardized incidence ratios (SIRs) and excess absolute risks (EARs) as calculated by use of data from the Surveillance, Epidemiology, and End Results Program. Cox regression models were used to estimate hazard ratios of developing subsequent sarcomas. Hazard ratios were reported as relative risks (RRs). Results We identified 108 patients with sarcomas that were diagnosed a median of 11 years after the diagnosis of Childhood Cancer. The risk of sarcoma was more than ninefold higher among Childhood Cancer survivors than among the general population (SIR = 9.02, 95% confidence interval [CI] = 7.44 to 10.93). The excess absolute risk of secondary sarcoma was 32.5 per 100 000 person-years (95% CI = 26.1 to 40.3 per 100 000 person-years). Higher standardized incidence ratios and excess absolute risks were associated with young age at primary diagnosis, primary sarcoma diagnosis, and a family history of Cancer. In a multivariable model, increased risk of secondary sarcoma was associated with radiation therapy (RR = 3.1, 95% CI = 1.5 to 6.2), with a primary diagnosis of sarcoma (RR = 10.1, 95% CI = 4.7 to 21.8), with a history of other secondary neoplasms (RR = 2.2, 95% CI = 1.1 to 4.5), and with treatment with higher doses of anthracyclines (RR = 2.3, 95% CI = 1.2 to 4.3) or alkylating agents (RR = 2.2, 95% CI = 1.1 to 4.6). Conclusion Childhood Cancer survivors appear to be at increased risk for secondary sarcomas compared with general population rates.
Yutaka Yasui - One of the best experts on this subject based on the ideXlab platform.
-
assisted reproductive technology outcomes in Childhood Cancer survivors a report from the Childhood Cancer survivor study
Journal of Clinical Oncology, 2020Co-Authors: Kimberly W Keefe, Andrea Lanes, Kayla Stratton, Daniel M Green, Eric J Chow, Kevin C Oeffinger, Sara E Barton, Lisa Diller, Yutaka Yasui, Wendy M LeisenringAbstract:10528Background: Some treatment exposures for Childhood Cancer reduce ovarian reserve. Registry-based evaluation has not been conducted for assisted reproductive technology (ART) outcomes of female...
-
long term risk of venous thromboembolism in survivors of Childhood Cancer a report from the Childhood Cancer survivor study
Journal of Clinical Oncology, 2018Co-Authors: Yutaka Yasui, Wendy M Leisenring, Todd M. Gibson, Qi Liu, Arin L Madenci, Brent R Weil, Andrew J Murphy, Rebecca M Howell, Christopher L TinkleAbstract:PurposeTo estimate the incidence of late-occurring venous thromboembolism (VTE) among survivors of Childhood Cancer and to identify risk factors for VTE to facilitate diagnosis and prevention.MethodsThe Childhood Cancer Survivor Study is a multi-institutional cohort of 24,355 5-year Childhood Cancer survivors (diagnosed between 1970 and 1999; median age at last follow-up, 28.7 years [range, 5.6 to 58.9 years]; median follow-up since diagnosis, 21.3 years [range, 5.0 to 39.2 years]) and 5,051 sibling participants. The primary end point was self-reported late (≥ 5 years after Cancer diagnosis) VTE. Rate ratios (RRs) were estimated with multivariable piecewise exponential models.ResultsLate VTE incidence among survivors and siblings was 1.1 and 0.5 events per 1,000 person-years, respectively (RR, 2.2; 95% CI, 1.7 to 2.8), with 2.5 excess events per 100 survivors over 35 years. Among survivors, risk factors for VTE were female sex (RR, 1.3; 95% CI, 1.1 to 1.6), cisplatin (reference none; 1 to 199 mg/m2: RR, 3...
-
Childhood Cancer survivorship research in minority populations: A position paper from the Childhood Cancer Survivor Study
Cancer, 2016Co-Authors: Smita Bhatia, Kevin C Oeffinger, Wendy M Leisenring, Paul C. Nathan, Joseph P. Neglia, Todd M. Gibson, Kirsten K. Ness, Qi Liu, Kevin R. Krull, Yutaka YasuiAbstract:By the middle of this century, racial/ethnic minority populations will collectively constitute 50% of the US population. This temporal shift in the racial/ethnic composition of the US population demands a close look at the race/ethnicity-specific burden of morbidity and premature mortality among survivors of Childhood Cancer. To optimize targeted long-term follow-up care, it is essential to understand whether the burden of morbidity borne by survivors of Childhood Cancer differs by race/ethnicity. This is challenging because the number of minority participants is often limited in current Childhood Cancer survivorship research, resulting in a paucity of race/ethnicity-specific recommendations and/or interventions. Although the overall Childhood Cancer incidence increased between 1973 and 2003, the mortality rate declined; however, these changes did not differ appreciably by race/ethnicity. The authors speculated that any racial/ethnic differences in outcome are likely to be multifactorial, and drew on data from the Childhood Cancer Survivor Study to illustrate the various contributors (socioeconomic characteristics, health behaviors, and comorbidities) that could explain any observed differences in key treatment-related complications. Finally, the authors outlined challenges in conducting race/ethnicity-specific Childhood Cancer survivorship research, demonstrating that there are limited absolute numbers of children who are diagnosed and survive Cancer in any one racial/ethnic minority population, thereby precluding a rigorous evaluation of adverse events among specific primary Cancer diagnoses and treatment exposure groups. Cancer 2016;122:2426-2439. © 2016 American Cancer Society.
-
telomere content and risk of second malignant neoplasm in survivors of Childhood Cancer a report from the Childhood Cancer survivor study
Clinical Cancer Research, 2014Co-Authors: Maria M. Gramatges, Yutaka Yasui, Leslie L. Robison, Gregory T. Armstrong, Louise C. Strong, Joseph P. Neglia, Fatih M Okcu, Smita BhatiaAbstract:Purpose: Shorter constitutional telomere length has been associated with increased Cancer incidence. Furthermore, telomere shortening is observed in response to intensive chemotherapy and/or ionizing radiation exposure. We aimed to determine whether less telomere content was associated with treatment-related second malignant neoplasms (SMN) in Childhood Cancer survivors. Experimental Design: Using a nested case–control design, 147 Cancer survivors with breast Cancer, thyroid Cancer, or sarcoma developing after treatment for Childhood Cancer (cases) were matched (1:1) with Childhood Cancer survivors without a SMN (controls). Cases and controls were matched by primary Cancer diagnosis, years since diagnosis, age at the time of sample collection, years of follow-up from Childhood Cancer diagnosis, exposure to specific chemotherapy agents, and to specific radiation fields. We performed conditional logistic regression using telomere content as a continuous variable to estimate ORs with corresponding 95% confidence intervals (CI) for development of SMN. ORs were also estimated for specific SMN types, i.e., breast Cancer, thyroid Cancer, and sarcoma. Results: There was an inverse relationship between telomere content and SMN, with an adjusted OR of 0.3 per unit change in telomere length to single-copy gene ratio (95% CI, 0.09–1.02; P = 0.05). Patients with thyroid Cancer SMN were less likely to have more telomere content (OR, 0.04; 95% CI, 0.00–0.55; P = 0.01), but statistically significant associations could not be demonstrated for breast Cancer or sarcoma. Conclusions: A relation between less telomere content and treatment-related thyroid Cancer was observed, suggesting that shorter telomeres may contribute to certain SMNs in Childhood Cancer survivors. Clin Cancer Res; 20(4); 904–11. ©2013 AACR .
-
TelomereContentandRiskofSecondMalignantNeoplasmin Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study
2014Co-Authors: Maria M. Gramatges, Yutaka Yasui, Leslie L. Robison, Gregory T. Armstrong, Louise C. Strong, Joseph P. Neglia, Qi Liu, M. Fatih Okcu, Smita BhatiaAbstract:Purpose: Shorter constitutional telomere length has been associated with increased Cancer incidence. Furthermore, telomere shortening is observed in response to intensive chemotherapy and/or ionizing radiation exposure. We aimed to determine whether less telomere content was associated with treatmentrelated second malignant neoplasms (SMN) in Childhood Cancer survivors. Experimental Design: Using a nested case–control design, 147 Cancer survivors with breast Cancer, thyroidCancer,orsarcomadevelopingaftertreatmentforChildhoodCancer(cases)werematched(1:1)with Childhood Cancer survivors without a SMN (controls). Cases and controls were matched by primary Cancer diagnosis, years since diagnosis, age at the time of sample collection, years of follow-up from Childhood Cancer diagnosis, exposure to specific chemotherapy agents, and to specific radiation fields. We performed conditional logistic regression using telomere content as a continuous variable to estimate ORs with corresponding95%confidence intervals(CI) fordevelopment ofSMN.ORswere alsoestimated forspecific SMN types, i.e., breast Cancer, thyroid Cancer, and sarcoma. Results: There was an inverse relationship between telomere content and SMN, with an adjusted OR of 0.3perunitchangeintelomerelengthtosingle-copygeneratio(95%CI,0.09–1.02;P ¼0.05).Patientswith thyroidCancerSMNwerelesslikelytohavemoretelomerecontent(OR,0.04;95%CI,0.00–0.55;P ¼0.01), but statistically significant associations could not be demonstrated for breast Cancer or sarcoma. Conclusions: A relation between less telomere content and treatment-related thyroid Cancer was observed, suggesting that shorter telomeres may contribute to certain SMNs in Childhood Cancer survivors. Clin Cancer Res; 20(4); 904–11. � 2013 AACR.
