Birth defects and childhood cancer in offspring of survivors of childhood cancer
D. M. Green, A. Fiorello, M. A. Zevon, B. Hall and N. Seigelstein
Department of Pediatrics, Roswell Park Cancer Institute, Buffalo, NY, USA.
OBJECTIVE: To determine the effect of chemotherapy for cancer during
childhood and adolescence on subsequent pregnancy outcome and the
occurrence of cancer in the offspring. DESIGN: We reviewed the history of
405 former patients with pediatric cancer. A self-administered
questionnaire was completed by members of a cohort of consecutively treated
patients who were aged 18 years or older at the most recent follow-up visit
and who were at least 5 years beyond the initial diagnosis of their cancer.
SETTING: Department of Pediatrics of a National Cancer Institute-designated
comprehensive cancer center. RESULTS: One hundred forty-eight patients
reported 280 pregnancies. Ninety-one of the patients who reported 1 or more
liveborn or stillborn infants following the completion of treatment had
received 1 or more chemotherapeutic agents as part of their treatment of
cancer. The frequency of congenital anomalies was 3.3% among the liveborn
offspring of the treated women and 3.3% among the liveborn offspring of the
spouses or female companions of the treated men. No cases of childhood
cancer have been diagnosed among the offspring. CONCLUSIONS: The present
data suggest that prior treatment with mutagenic chemotherapeutic agents,
in the dosage ranges examined, does not increase the frequency of
congenital anomalies in the offspring of former pediatric and adolescent
patients with cancer. Although no cases of childhood cancer have been
observed thus far among the offspring, additional follow-up is necessary to
adequately assess their risk of childhood cancer.
