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Author Notes:

Corresponding Author : Karen Wasilewski-Masker, MD, MSc, The Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, 5455 Meridian Mark Road, Suite 400, Atlanta, GA 30342, Tel.: (404)785-3240, Fax: (404)785-3600, karen.wasilewski@choa.org

"This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."

The authors wish to acknowledge the assistance of Anna Sutter-Iwinski, M.S., Radiation Oncology Department, Emory University School of Medicine, Atlanta, Georgia, for assistance in chart review, and David H. Howard, Ph.D., Department of Health Policy and Management, Emory University, Atlanta, Georgia, for his methodological assistance.

The authors have no conflicts of interest to disclose.

Subjects:

Research Funding:

This research was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR000454.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • Hematology
  • Pediatrics
  • adverse effect
  • childhood cancer
  • genitourinary
  • ifosfamide
  • whole body irradiation
  • TERM-FOLLOW-UP
  • EFFECTS SURVEILLANCE SYSTEM
  • CHILDRENS ONCOLOGY GROUP
  • IFOSFAMIDE-INDUCED NEPHROTOXICITY
  • QUALITY-OF-LIFE
  • CHILDHOOD-CANCER
  • SARCOMA PATIENTS
  • RENAL-FUNCTION
  • WILMS-TUMOR
  • INTERGROUP RHABDOMYOSARCOMA

Yield of Urinalysis Screening in Pediatric Cancer Survivors

Tools:

Journal Title:

Pediatric Blood and Cancer

Volume:

Volume 63, Number 5

Publisher:

, Pages 893-900

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: The Children's Oncology Group (COG) publishes consensus guidelines with screening recommendations for early identification of treatment-related morbidities among childhood cancer survivors. We sought to estimate the yield of recommended yearly urinalysis screening for genitourinary complications as per Version 3.0 of the COG Long-Term Follow-Up Guidelines and identify possible risk factors for abnormal screening in a survivor population. Procedure: A database of pediatric cancer survivors evaluated between January 2008 and March 2012 at Children's Healthcare of Atlanta was queried for survivors at risk for genitourinary late effects. The frequency of abnormal urinalyses (protein ≥1+ and/or presence of glucose and/or ≥5 red blood cells per high power field) was estimated. Risk factors associated with abnormal screening were identified. Results: Chart review identified 773 survivors (57% male; 67% Caucasian; 60% leukemia/lymphoma survivors; mean age at diagnosis, 5.7 years [range: birth to 17.7 years]; time from diagnosis to initial screening, 7.6 years [range: 2.3 to 21.5 years]) who underwent urinalysis. Abnormal results were found in 78 (5.3%) of 1,484 total urinalyses. Multivariable analysis revealed higher dose ifosfamide (odds ratio [OR] = 6.8, 95% confidence interval [CI] 2.9-16.0) and total body irradiation (TBI, OR = 3.0, 95% CI 1.0-8.4) as significant risk factors for abnormal initial urinalysis screening. Conclusions: Pediatric cancer survivors exposed to higher dose ifosfamide or TBI may be at higher risk of abnormal findings on urinalysis screening. Targeted screening of these higher risk patients should be considered.

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© 2016 Wiley Periodicals, Inc. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving

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