EClinicalMedicine (Mar 2024)
Recommendations for surveillance of pulmonary dysfunction among childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group
- Maria Otth,
- Rahel Kasteler,
- Renée L. Mulder,
- Jennifer Agrusa,
- Saro H. Armenian,
- Dana Barnea,
- Anne Bergeron,
- Neel S. Bhatt,
- Stephen J. Bourke,
- Louis S. Constine,
- Myrofora Goutaki,
- Daniel M. Green,
- Ulrike Hennewig,
- Veronique Houdouin,
- Melissa M. Hudson,
- Leontien Kremer,
- Philipp Latzin,
- Antony Ng,
- Kevin C. Oeffinger,
- Christina Schindera,
- Roderick Skinner,
- Grit Sommer,
- Saumini Srinivasan,
- Dennis C. Stokes,
- Birgitta Versluys,
- Nicolas Waespe,
- Daniel J. Weiner,
- Andrew C. Dietz,
- Claudia E. Kuehni
Affiliations
- Maria Otth
- Department of Oncology, Haematology, Immunology, Stem Cell Transplantation and Somatic Gene Therapy, University Children's Hospital Zurich, Zurich, Switzerland; Pediatric Hematology-Oncology Center, Children's Hospital of Eastern Switzerland, St Gallen, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Rahel Kasteler
- Department of Oncology, Haematology, Immunology, Stem Cell Transplantation and Somatic Gene Therapy, University Children's Hospital Zurich, Zurich, Switzerland; Pediatric Hematology-Oncology Center, Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
- Renée L. Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Jennifer Agrusa
- Department of Pediatric Hematology Oncology, C.S. Mott Children's Hospital, University of Michigan, Michigan, USA
- Saro H. Armenian
- Department of Pediatrics, City of Hope, Duarte, CA, USA
- Dana Barnea
- Department of Hematology and Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Anne Bergeron
- Hôpitaux Universitaires de Genève, Université de Genève, Genève, Switzerland
- Neel S. Bhatt
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Stephen J. Bourke
- Department of Respiratory Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
- Louis S. Constine
- Departments of Radiation Oncology and Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
- Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Daniel M. Green
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
- Ulrike Hennewig
- University Hospital of Giessen and Marburg, Pediatric Hematology and Oncology, Giessen, Germany
- Veronique Houdouin
- AP-HP, Hôpital Robert Debré, Service de Pneumopédiatrie, Paris, France
- Melissa M. Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
- Leontien Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Antony Ng
- Department of Paediatric Oncology, Royal Hospital for Children, Bristol, UK
- Kevin C. Oeffinger
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, USA
- Christina Schindera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Division of Pediatric Oncology/Haematology, University Children's Hospital Basel, University of Basel, Basel, Switzerland
- Roderick Skinner
- Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital and Newcastle University Centre for Cancer, Newcastle upon Tyne, UK
- Grit Sommer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Saumini Srinivasan
- Division of Pulmonology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
- Dennis C. Stokes
- Division of Pulmonology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
- Birgitta Versluys
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Nicolas Waespe
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Pediatric Hematology and Oncology, University Children's Hospital Bern, University of Bern, Bern, Switzerland; CANSEARCH Research Platform for Paediatric Oncology and Haematology, Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Daniel J. Weiner
- Division of Pediatric Pulmonology, University of Pittsburgh, Pittsburgh, PA, USA
- Andrew C. Dietz
- Shape Therapeutics, Inc., Seattle, WA, USA
- Claudia E. Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Pediatric Hematology and Oncology, University Children's Hospital Bern, University of Bern, Bern, Switzerland; Corresponding author. Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
- Journal volume & issue
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Vol. 69
p. 102487
Abstract
Summary: Childhood, adolescent, and young adult (CAYA) cancer survivors are at risk of pulmonary dysfunction. Current follow-up care guidelines are discordant. Therefore, the International Late Effects of Childhood Cancer Guideline Harmonization Group established and convened a panel of 33 experts to develop evidence-based surveillance guidelines. We critically reviewed available evidence regarding risk factors for pulmonary dysfunction, types of pulmonary function testing, and timings of surveillance, then we formulated our recommendations. We recommend that CAYA cancer survivors and healthcare providers are aware of reduced pulmonary function risks and pay vigilant attention to potential symptoms of pulmonary dysfunction, especially among survivors treated with allogeneic haematopoietic stem cell transplantation, thoracic radiotherapy, and thoracic surgery. Based on existing limited evidence and current lack of interventions, our panel recommends pulmonary function testing only for symptomatic survivors. Since scarce existing evidence informs our recommendation, we highlight the need for prospective collaborative studies to address pulmonary function knowledge gaps among CAYA cancer survivors.
