Table 2.
Factor | Example 1. Leukemia | Example 2. Solid tumor |
---|---|---|
Host | 3-year-old white male | 16-year-old black female |
Tumor | Acute lymphoblastic leukemia, B lineage, average risk, without CNS involvement | Embryonal rhabdomyosarcoma of the chest wall, stage II |
Treatment | Vincristine | Vincristine |
Corticosteroids | Dactinomycin | |
Antimetabolites (PO, IV, intrathecal) | Chest radiation (36 Gy) | |
Asparaginase | ||
Cyclophosphamide (moderate dose) | ||
Doxorubicin (low dose) | ||
Potential late effects | Peripheral neuropathy | Peripheral neuropathy |
Osteopenia/osteoporosis | Cardiac complications (cardiomyopathy, congestive heart failure, arrhythmia, subclinical left ventricular dysfunction, valvular disease, atherosclerotic heart disease, myocardial infarction, pericarditis, pericardial fibrosis) | |
Osteonecrosis | Pulmonary complications (fibrosis, interstitial pneumonitis, restrictive/obstructive lung disease) | |
Cataracts | Esophageal stricture | |
Hepatic dysfunction | Breast tissue hypoplasia | |
Renal insufficiency | Breast cancer | |
Neurocognitive deficits | Scoliosis/kyphosis | |
Leukoencephalopathy | Shortened trunk height | |
Hemorrhagic cystitis, bladder malignancy | Secondary benign or malignant neoplasms in radiation field | |
Secondary myelodysplasia or myeloid leukemia | ||
Gonadal dysfunction | ||
Cardiomyopathy, congestive heart failure, arrhythmia | ||
Dental maldevelopment, periodontal disease, excessive dental caries | ||
Genetics/familial | Diabetes mellitus, type 2 | Hypertension |
Early coronary artery disease | ||
Comorbid conditions | Obesity | Hypertension |
Health behaviors | Sedentary lifestyle | Smoker |
Aging | Bone mineral (osteoporosis) | Cardiomyopathy |
CNS indicates central nervous system; PO, oral; IV, intravenous; Gy, Gray.