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Cancer. 2014 Aug 15;120(16):2514-21. doi: 10.1002/cncr.28763. Epub 2014 May 13.

Infections among long-term survivors of childhood and adolescent cancer: a report from the Childhood Cancer Survivor Study.

Author information

1
Pediatric Hematology/Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.

Abstract

BACKGROUND:

Little is known about infections among adult survivors of childhood cancer. The authors report the occurrence of infections and risk factors for infections in a large cohort of survivors of childhood cancer.

METHODS:

The Childhood Cancer Survivor Study cohort was used to compare incidence rates of infections among 12,360 5-year survivors of childhood cancer with the rates of 4023 siblings. Infection-related mortality of survivors was compared with that of the US population. Demographic and treatment variables were analyzed using Poisson regression to determine the rate ratios (RRs) and corresponding 95% confidence intervals (CIs) for associations with infectious complications.

RESULTS:

Compared with the US population, survivors were at an increased risk of death from infectious causes (standardized mortality ratio [SMR], 4.2; 95% CI, 3.2-5.4), with the greatest risk observed among females (SMR, 3.2; 95% CI, 1.5-6.9) and among those who had been exposed to total body irradiation (SMR, 7.8; 95% CI, 1.8-33.0). Survivors also reported higher rates than siblings of overall infectious complications (RR, 1.3; 95% CI, 1.2-1.4) and higher rates of all categories of infection.

CONCLUSIONS:

Survivors of childhood cancer remain at elevated risk for developing infectious-related complications, and they have a higher risk of infection-related mortality years after therapy. Further investigation is needed to provide insight into the mechanisms for the observed excess risks.

KEYWORDS:

adolescent cancer; childhood cancer; infections; late effects; survivorship

PMID:
24824782
PMCID:
PMC4159255
DOI:
10.1002/cncr.28763
[Indexed for MEDLINE]
Free PMC Article

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