Renal late effects in patients treated for cancer in childhood: A report from the Children's Oncology Group

Authors

  • Deborah P. Jones MD,

    Corresponding author
    1. University of Tennessee Health Science Center, Children's Foundation Research Center at Le Bonheur Children's Medical Center, Memphis, Tennessee
    • 50 North Dunlap, Room 301, Children's Foundation Research Center at Le Bonheur Children's Medical Center, Memphis, TN 38103.
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    • Professor of Pediatrics.

  • Sheri L. Spunt MD,

    1. Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
    2. Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
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    • Associate Member.

  • Daniel Green MD,

    1. Department of Epidemiology and Cancer Prevention, St. Jude Children's Research Hospital, Memphis, Tennessee
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    • Associate Professor.

  • James E. Springate MD

    1. Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York
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    • Member.


Abstract

Improvements in childhood cancer therapy have led to increasing numbers of long-term survivors. These survivors are at risk for a variety of late effects due to the disease itself, treatment exposures (surgery, chemotherapy, and radiotherapy), underlying medical problems, and health behaviors. The COG LTFU Guidelines are risk-based, exposure-related recommendations for the identification and management of late effects due to therapies utilized in the treatment of childhood cancer, and are designed for asymptomatic survivors presenting for routine medical follow-up 2 or more years after completion of cancer therapy. The COG Guidelines Task Force on Urinary Tract Complications conducted an extensive review of the medical literature via MEDLINE. Specific treatment exposures which were reviewed include nephrectomy, chemotherapy regimens known to be nephrotoxic (cisplatin, carboplatin, ifosfamide, and methotrexate), and renal irradiation. Literature sources were ranked according to the strength of evidence and are cited in the review. This review summarizes the literature that supported the recommendations for cancer survivors at risk for nephrotoxicity previously outlined in the Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers (COG LTFU Guidelines). Pediatr Blood Cancer 2008;51:724–731. © 2008 Wiley-Liss, Inc.

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