Assessment of Late Effects in Childhood Cancer Survivors: A Cross Sectional Study
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SCIENTIFIC LETTER
Assessment of Late Effects in Childhood Cancer Survivors: A Cross Sectional Study Venkata Naga Malleswari Muddana 1
&
Biswajit Dubashi 1
&
S. Nirmala Devi 1 & Smita Kayal 1 & Prasanth Ganesan 1
Received: 29 August 2020 / Accepted: 22 October 2020 # Dr. K C Chaudhuri Foundation 2020
To the Editor: Improved survival rates of childhood cancer have led to increased recognition of late effects of therapy [1]. The present study evaluated the profile of adverse long term effects in children diagnosed with hematological or solid tumor before the age of 18 y at our centre and completed at least two years post cancer therapy. Records of 62 eligible children who attended the long term follow-up clinic during the study period were analysed. A total of 83 late effect events were identified by clinical assessment and specific organ function test based on therapeutic exposure in each child [2]. The median age at follow-up and duration of follow-up were 10 y (4–23) and 4 y (2–9) respectively. Growth and nutritional status were assessed at diagnosis and follow-up. Twenty eight children (45.2%) were found to be underweight for age out of whom 15 (53.6%) had normal status at baseline. Seven children (11.3%) had overweightobesity and six (9.6%) had short stature post treatment, all of whom were normal at diagnosis. There was no statistical difference between hematolymphoid and solid tumors in terms of nutritional status. Six (9.7%) had early or delayed puberty with normal hormonal studies. Twenty two children underwent spirometry and two (9.1%) were found to have restrictive pattern. IQ assessment was performed in 19 and five (26.3%) were found to have mild to borderline mental retardation. Neurological examination was normal in all these children. Seven (35%) of the 20 children who underwent thyroid function testing had elevated TSH with normal free T4 levels suggestive of subclinical hypothyroidism. Three (9.3%) among the 31 tested had bone mineral density scores * Biswajit Dubashi [email protected] 1
Department of Medical Oncology, Regional Cancer Centre, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India
suggestive of osteopenia. The incidence of other long-term effects was minimal. A significant proportion of children had late effects of treatment, although those causing major disability were few. Most were asymptomatic and related to nutritional status and subclinical hypothyroidism. In the absence of a suitable control group, the adverse events cannot be conclusively imputed to cancer therapy. Also the population was younger and duration of follow-up was shorter compared to other studies [3–5]. The high frequency of asymptomatic effects and those amenable for intervention underscores the importance of continuing assessment.
Compliance with Ethical Standards Conflict of Interest None.
References 1. 2.
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Scott JX, Latha MS, Aruna R. Approach to metabolic syndrome in childhood cancer survivors. Indian J Cancer. 2015;52:169–72. Children
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