Special Issue "Acute and Long-Term Sequelae of Childhood Cancer Therapy"

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A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: closed (31 May 2014)

Special Issue Editors

Guest Editor
Dr. Paul Nathan (Website)

Director, AfterCare Program, Division of Hematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
Interests: childhood cancer survivorship; health care utilization; anthracycline cardiotoxicity
Guest Editor
Dr. Lillian Sung

Staff Physician Division of Hematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
Interests: infectious complications; supportive care; mucositis; quality of life

Special Issue Information

Dear Colleagues,

Tremendous improvements in the probability of long-term survival in children newly diagnosed with cancer have allowed for an increased focus on minimizing both the acute toxicities and the long-term sequelae (late effects) of cancer therapies. The focus of research in these areas has expanded from efforts to document the risks of acute and late effect, to exploring methods to identify those children at greatest risk, and to prevent or minimize the risks for toxicity. This special issue of Children will serve as a forum for discussion of the latest research in symptom management and detection/prevention of late effects. Both reviews and original research publications will be considered for publication. Examples could include manuscripts that discuss acute toxicities such as infection, mucositis and emesis, or late effects such as cardiac toxicity, neurocognitive deficits and hearing loss.

We look forward to receiving your contributions.

Drs. Paul Nathan
Lillian Sung
Guest Editors

Submission

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed Open Access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. For the first couple of issues the Article Processing Charge (APC) will be waived for well-prepared manuscripts. English correction and/or formatting fees of 250 CHF (Swiss Francs) will be charged in certain cases for those articles accepted for publication that require extensive additional formatting and/or English corrections.


Keywords

  • late effects
  • survivorship
  • treatment toxicity
  • childhood cancer
  • emesis
  • hearing loss
  • nutrition
  • infection
  • supportive care
  • mucositis
  • transition
  • care plans
  • anthracycline cardiotoxicity
  • neurocognitive outcomes

Published Papers (10 papers)

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Research

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Open AccessArticle Understanding the Health Behaviors of Survivors of Childhood and Young-Adult Cancer: Preliminary Analysis and Model Development
Children 2015, 2(2), 174-190; doi:10.3390/children2020174
Received: 3 December 2014 / Revised: 10 April 2015 / Accepted: 14 April 2015 / Published: 7 May 2015
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Abstract
The current study presents preliminary correlational data used to develop a model depicting the psychosocial pathways that lead to the health behaviors of survivors of childhood and young-adult cancer. Data collected from a sample of 18- to 30-year-old cancer survivors (n = [...] Read more.
The current study presents preliminary correlational data used to develop a model depicting the psychosocial pathways that lead to the health behaviors of survivors of childhood and young-adult cancer. Data collected from a sample of 18- to 30-year-old cancer survivors (n = 125) was used to examine the relations among interpersonal support and nonsupport, personal agency, avoidance, depressive symptoms and self-efficacy as they related to health behaviors. The outcome measures examined included tobacco and alcohol use, diet, exercise, sunscreen use, medication compliance and follow-up/screening practices. Correlational analyses revealed a number of significant associations among variables. Results are used to inform the development of a health behavior model. Implications for health promotion and survivorship programming are discussed, as well as directions for future research. Full article
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)

Review

Jump to: Research

Open AccessReview Secondary Malignant Neoplasms Following Haematopoietic Stem Cell Transplantation in Childhood
Children 2015, 2(2), 146-173; doi:10.3390/children2020146
Received: 10 December 2014 / Revised: 3 April 2015 / Accepted: 8 April 2015 / Published: 21 April 2015
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Abstract
Improving survival rates in children with malignancy have been achieved at the cost of a high frequency of late adverse effects of treatment, especially in intensively treated patients such as those undergoing haematopoietic stem cell transplantation (HSCT), many of whom suffer the [...] Read more.
Improving survival rates in children with malignancy have been achieved at the cost of a high frequency of late adverse effects of treatment, especially in intensively treated patients such as those undergoing haematopoietic stem cell transplantation (HSCT), many of whom suffer the high burden of chronic toxicity. Secondary malignant neoplasms (SMNs) are one of the most devastating late effects, cause much morbidity and are the most frequent cause of late (yet still premature) treatment-related mortality. They occur in up to 7% of HSCT recipients by 20 years post-HSCT, and with no evidence yet of a plateau in incidence with longer follow-up. This review describes the epidemiology, pathogenesis, clinical features and risk factors of the three main categories of post-HSCT SMNs. A wide range of solid SMNs has been described, usually occurring 10 years or more post-HSCT, related most often to previous or conditioning radiotherapy. Therapy-related acute myeloid leukaemia/myelodysplasia occurs earlier, typically three to seven years post-HSCT, mainly in recipients of autologous transplant and is related to previous alkylating agent or topoisomerase II inhibitor chemotherapy. Post-transplant lymphoproliferative disorders occur early (usually within two years) post-HSCT, usually presenting as Epstein-Barr virus-related B cell non-Hodgkin lymphoma. Full article
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)
Open AccessReview Impairments that Influence Physical Function among Survivors of Childhood Cancer
Children 2015, 2(1), 1-36; doi:10.3390/children2010001
Received: 20 October 2014 / Accepted: 18 December 2014 / Published: 8 January 2015
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Abstract
Children treated for cancer are at increased risk of developing chronic health conditions, some of which may manifest during or soon after treatment while others emerge many years after therapy. These health problems may limit physical performance and functional capacity, interfering with [...] Read more.
Children treated for cancer are at increased risk of developing chronic health conditions, some of which may manifest during or soon after treatment while others emerge many years after therapy. These health problems may limit physical performance and functional capacity, interfering with participation in work, social, and recreational activities. In this review, we discuss treatment-induced impairments in the endocrine, musculoskeletal, neurological, and cardiopulmonary systems and their influence on mobility and physical function. We found that cranial radiation at a young age was associated with a broad range of chronic conditions including obesity, short stature, low bone mineral density and neuromotor impairments. Anthracyclines and chest radiation are associated with both short and long-term cardiotoxicity. Although numerous chronic conditions are documented among individuals treated for childhood cancer, the impact of these conditions on mobility and function are not well characterized, with most studies limited to survivors of acute lymphoblastic leukemia and brain tumors. Moving forward, further research assessing the impact of chronic conditions on participation in work and social activities is required. Moreover, interventions to prevent or ameliorate the loss of physical function among children treated for cancer are likely to become an important area of survivorship research. Full article
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)
Open AccessReview Integrative Therapy Use for Management of Side Effects and Toxicities Experienced by Pediatric Oncology Patients
Children 2014, 1(3), 424-440; doi:10.3390/children1030424
Received: 16 September 2014 / Revised: 11 October 2014 / Accepted: 29 October 2014 / Published: 14 November 2014
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Abstract
Integrative Therapies (IT), otherwise known as Complementary and Alternative Medicine, are widely used among pediatric oncology patients, despite a paucity of available evidence. This review summarizes surveys that describe the prevalence of IT use by pediatric oncology patients, both during therapy and [...] Read more.
Integrative Therapies (IT), otherwise known as Complementary and Alternative Medicine, are widely used among pediatric oncology patients, despite a paucity of available evidence. This review summarizes surveys that describe the prevalence of IT use by pediatric oncology patients, both during therapy and in survivorship, as well as the modalities being used. Additionally, the evidence that exists for specific treatments that appear to be efficacious in controlling specific symptoms is described. Finally, there are recommendations for practitioners on how to best counsel patients about IT use. Full article
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)
Open AccessReview Health Behaviors of Childhood Cancer Survivors
Children 2014, 1(3), 355-373; doi:10.3390/children1030355
Received: 18 August 2014 / Revised: 11 October 2014 / Accepted: 15 October 2014 / Published: 22 October 2014
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Abstract
There has been a dramatic increase in the number of childhood cancer survivors living to an old age due to improved cancer treatments. However, these survivors are at risk of numerous late effects as a result of their cancer therapy. Engaging in [...] Read more.
There has been a dramatic increase in the number of childhood cancer survivors living to an old age due to improved cancer treatments. However, these survivors are at risk of numerous late effects as a result of their cancer therapy. Engaging in protective health behaviors and limiting health damaging behaviors are vitally important for these survivors given their increased risks. We reviewed the literature on childhood cancer survivors’ health behaviors by searching for published data and conference proceedings. We examine the prevalence of a variety of health behaviors among childhood cancer survivors, identify significant risk factors, and describe health behavior interventions for survivors. Full article
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)
Open AccessReview Clinical Guidelines for the Care of Childhood Cancer Survivors
Children 2014, 1(2), 227-240; doi:10.3390/children1020227
Received: 30 June 2014 / Revised: 26 August 2014 / Accepted: 2 September 2014 / Published: 12 September 2014
Cited by 3 | PDF Full-text (471 KB) | HTML Full-text | XML Full-text
Abstract
The Long-Term Follow-Up Guidelines for survivors of childhood, adolescent, and young adult cancers are evidence- and consensus-based guidelines that have been developed and published by the Children’s Oncology Group (COG) Late Effects Committee, Nursing Discipline, and the Patient Advocacy Committee. Originally published [...] Read more.
The Long-Term Follow-Up Guidelines for survivors of childhood, adolescent, and young adult cancers are evidence- and consensus-based guidelines that have been developed and published by the Children’s Oncology Group (COG) Late Effects Committee, Nursing Discipline, and the Patient Advocacy Committee. Originally published in 2004, the guidelines are currently in version 3.0. While the COG guidelines have been praised as a model for providing risk-based survivorship care, adherence has not been uniform. Reasons for this gap include unawareness on the part of the survivor and/or care team as well as disagreement about the individual recommendations. In some cases, the burden of testing (such as annual echocardiography or repeat pulmonary function testing) may be too great. A small number of intervention studies have documented improved adherence to guideline recommendations with dissemination of informational material. Future studies should focus on individualizing screening recommendations, as well as identifying unnecessary testing. Full article
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)
Open AccessReview Preserving Fertility in Children and Adolescents with Cancer
Children 2014, 1(2), 166-185; doi:10.3390/children1020166
Received: 31 May 2014 / Revised: 21 July 2014 / Accepted: 23 July 2014 / Published: 26 August 2014
Cited by 2 | PDF Full-text (627 KB) | HTML Full-text | XML Full-text
Abstract
In the face of excellent survival rates for pediatric and adolescent cancer, preserving the opportunity to have biological children is an important component of long term quality of life. Yet, modern chemotherapeutic regimens continue to pose a threat to fertility. The only [...] Read more.
In the face of excellent survival rates for pediatric and adolescent cancer, preserving the opportunity to have biological children is an important component of long term quality of life. Yet, modern chemotherapeutic regimens continue to pose a threat to fertility. The only fertility preservation methods available to pre-pubertal children of both genders is cryopreservation of gonadal tissue, a highly experimental intervention, or shielding/re-location of reproductive tissue in the setting of radiation. These techniques are available in the post pubertal population as well, but post pubertal patients also have the option for cryopreservation of gametes, a process that is much simpler in males than females. For this reason, prior to the initiation of therapy, sperm banking should be considered standard of care for males, while consideration of embryo or oocyte cryopreservation should be limited to those females at risk of developing ovarian failure. Attention to reproductive health and fertility preservation should continue after the completion of therapy. Establishing programs that streamline access to current fertility preservation techniques will assist in ensuring that all eligible patients can avail themselves of current options. Full article
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)
Open AccessReview Nutritional Counseling in Survivors of Childhood Cancer: An Essential Component of Survivorship Care
Children 2014, 1(2), 107-118; doi:10.3390/children1020107
Received: 4 June 2014 / Revised: 31 July 2014 / Accepted: 1 August 2014 / Published: 14 August 2014
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Abstract
There is a growing body of evidence suggesting that nutritional status during treatment for cancer has a significant impact on treatment-related toxicities and outcomes among children and adolescents with cancer. The effects of nutritional status appear to extend into survivorship with a [...] Read more.
There is a growing body of evidence suggesting that nutritional status during treatment for cancer has a significant impact on treatment-related toxicities and outcomes among children and adolescents with cancer. The effects of nutritional status appear to extend into survivorship with a large proportion of survivors at risk for a variety of nutrition-related morbidities. The influence of dietary intake on overall treatment outcomes and long-term morbidities is largely unknown. In adults, evidence suggests that greater adherence to cancer prevention dietary guidelines improves long-term health outcomes among survivors of cancer. Surveys describing dietary intake among survivors of childhood cancer have found that most survivors are not meeting the recommended guidelines for many dietary nutrients and this may have an unfavorable effect on nutrition-related outcomes. However, more research is needed in this area so that well-designed clinical trials may be developed and tested. This review presents an overview of the existing literature describing dietary intake among survivors of childhood cancer, the clinical implications of reported dietary behaviors among survivors, and identifies areas for future research. Full article
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)
Open AccessReview Predicting Adverse Health Outcomes in Long-Term Survivors of a Childhood Cancer
Children 2014, 1(2), 63-73; doi:10.3390/children1020063
Received: 2 June 2014 / Revised: 4 July 2014 / Accepted: 7 July 2014 / Published: 15 July 2014
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Abstract
More than 80% of children and young adults diagnosed with invasive cancer will survive five or more years beyond their cancer diagnosis. This population has an increased risk for serious illness- and treatment-related morbidity and premature mortality. A number of these adverse [...] Read more.
More than 80% of children and young adults diagnosed with invasive cancer will survive five or more years beyond their cancer diagnosis. This population has an increased risk for serious illness- and treatment-related morbidity and premature mortality. A number of these adverse health outcomes, such as cardiovascular disease and some second primary neoplasms, either have modifiable risk factors or can be successfully treated if detected early. Absolute risk models that project a personalized risk of developing a health outcome can be useful in patient counseling, in designing intervention studies, in forming prevention strategies, and in deciding upon surveillance programs. Here, we review existing absolute risk prediction models that are directly applicable to survivors of a childhood cancer, discuss the concepts and interpretation of absolute risk models, and examine ways in which these models can be used applied in clinical practice and public health. Full article
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)
Open AccessReview Endocrine Disorders in Childhood Cancer Survivors Treated with Haemopoietic Stem Cell Transplantation
Children 2014, 1(1), 48-62; doi:10.3390/children1010048
Received: 22 May 2014 / Revised: 17 June 2014 / Accepted: 18 June 2014 / Published: 23 June 2014
Cited by 1 | PDF Full-text (569 KB) | HTML Full-text | XML Full-text
Abstract
The increasing number of haemopoietic stem cell transplantations (HSCT) taking place worldwide has offered a cure to many high risk childhood malignancies with an otherwise very poor prognosis. However, HSCT is associated with an increased risk of morbidity and premature death, and [...] Read more.
The increasing number of haemopoietic stem cell transplantations (HSCT) taking place worldwide has offered a cure to many high risk childhood malignancies with an otherwise very poor prognosis. However, HSCT is associated with an increased risk of morbidity and premature death, and patients who have survived the acute complications continue to face lifelong health sequelae as a result of the treatment. Endocrine dysfunction is well described in childhood HSCT survivors treated for malignancies. The endocrine system is highly susceptible to damage from the conditioning therapy, such as, alkylating agents and total body irradiation, which is given prior stem cell infusion. Although not immediately life-threatening, the impact of these abnormalities on the long term health and quality of life in these patients may be considerable. The prevalence, risk factors, clinical approaches to investigations and treatments, as well as the implications of ongoing surveillance of endocrine disorders in childhood HSCT survivors, are discussed in this review. Full article
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)

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