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


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

Deadline for manuscript submissions: closed (31 May 2014)

Special Issue Editors

Guest Editor
Dr. Paul Nathan
Director, AfterCare Program, Division of Hematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
Website: http://www.sickkids.ca/AboutSickKids/Directory/People/N/Paul-Nathan.html
E-Mail: paul.nathan@sickkids.ca
Phone: +1 416 813 7654 x.208454
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
E-Mail: lillian.sung@sickkids.ca
Phone: +1 416 813 5287
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


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.


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

Published Papers (2 papers)

by  and
Children 2014, 1(2), 63-73; doi:10.3390/children1020063
Received: 2 June 2014; in revised form: 4 July 2014 / Accepted: 7 July 2014 / Published: 15 July 2014
Show/Hide Abstract | PDF Full-text (367 KB) | HTML Full-text | XML Full-text

by  and
Children 2014, 1(1), 48-62; doi:10.3390/children1010048
Received: 22 May 2014; in revised form: 17 June 2014 / Accepted: 18 June 2014 / Published: 23 June 2014
Show/Hide Abstract | PDF Full-text (569 KB)

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Retrospective Chart Review of Antimetabolite Toxicities in South Texas Pediatric Cancer Patients
Author: Jonathan P. Lam, Erica Frausto-Garcia, Chatchwin Assanasen,  Brad Pollock, Gregory J. Aune
Affiliations: 1 University of Texas Health Science Center at San Antonio School of Medicine, Greehey Children’s Cancer Research Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX
2 Department of Pediatrics, Division of Hematology-Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX
3 Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, TX
4 Department of Pediatrics, Division of Hematology-Oncology, Greehey Children’s Cancer Research Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX
Abstract: Antimetabolites, including 6-mercaptopurine (6-MP) and methotrexate (MTX), are frequently used as chemotherapeutic agents; however, their use is not benign as there are several dose-limiting toxicities.  Acute lymphoblastic leukemia is the most common childhood malignancy and represents approximately 23% of cancer diagnoses in children under 15 years old.  Five year survival rates are now over 80% thanks to the advancement of modern medicine and chemotherapy; however, racial and ethnic differences in the survival of childhood ALL are well-known and prove to be a major obstacle in continuing to improve patient morbidity and mortality.  A retrospective chart review was conducted to quantify the incidence of antimetabolite toxicity in the South Texas population to help further explore these differences.  Procedure. A total of 241 patients were identified that received the antimetabolites 6-MP and MTX between 1997-2012 at Christus Santa Rosa in San Antonio, TX.  A chart review was performed to quantify the incidence of chemotherapy-induced organ toxicities, including hepatotoxicity, pancreatitis, and CNS toxicity. Results. We found that age had a significant correlation with the development of hepatotoxicity (P=0.002) and pancreatitis (P=0.041).  However, gender and ethnicity had no significant correlation with the development of neurotoxicity (P=0.22; P=0.09), hepatotoxicity (P=0.06; P=0.81), or pancreatitis (P=0.31; P=0.16).  Conclusion. Our results suggest that in our South Texas population of cancer patients, antimetabolite toxicities occur at higher rates in older patients, and we have a very high frequency of neurotoxicity.  Prospective studies are needed to evaluate the true incidence.
Keywords: childhood cancer, antimetabolites, toxicity

Title: Predicting adverse health outcomes in long-term survivors of a childhood cancer: clinical and public health practice
Chaya S. Moskowitz and Kevin C. Oeffinger
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.

Last update: 7 March 2014

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