Table 4:
Risk factors associated with organ-specific wait-list registration or transplantation in survivors of childhood cancer
| *Kidney wait-list registration or transplantation | ||||
|---|---|---|---|---|
| Treatment | Exposure | Hazard Ratio |
95% Confidence Interval |
p-value |
| Ifosfamide | No | 1·0 | referent | |
| Yes | 24.9 | (7·4, 83·5) | <0·0001 | |
| IV or IM Methotrexate | No | 1·0 | referent | |
| Yes | 0·6 | (0·3, 1·5) | 0·30 | |
| Mean Kidney Radiation Dose | None | 1·0 | referent | |
| (Gy) | >0 to 10† | 0·4 | (0·2, 0·7) | 0·0040 |
| > 10 to 15† | 1.6 | (0·6, 4·0) | 0.35 | |
| > 15 to 20† | 3.6 | (1·5, 8·5) | 0·0041 | |
| > 20† | 4·6 | (1·1, 19·6) | 0·040 | |
| TBI | 6.9 | (2·3, 21.1) | 0·0007 | |
| Nephrectomy | No | 1·0 | referent | |
| (all unilateral) | Yes | 4·2 | (2·3, 7·7) | <0·0001 |
| Age at Primary Cancer | 0–4 | 1·5 | (0·6, 3·7) | 0·38 |
| Diagnosis (years) | 5–9 | 1·2 | (0·4, 3·3) | 0·72 |
| 10–14 | 0·8 | (0·2, 2·6) | 0·71 | |
| 15–20 | 1·0 | referent | ||
| *Heart wait-list registration or transplantation | ||||
| Treatment factor | Level of exposure | Hazard Ratio |
95% Confidence Interval |
p-value |
| Cyclophosphamide (mg/m2) | None | referent | ||
| >0 to 10000 | 0·3 | (0·1, 0·6) | 0·0018 | |
| >10000 to 20000 | 0·8 | (0·4, 1·7) | 0·57 | |
| >20000 | 1·3 | (0·5, 3·7) | 0·61 | |
| Anthracyclines (mg/m2) | None | referent | ||
| >0 to 150 | 8·4 | (2·2, 32·6) | 0·002 | |
| >150 to 300 | 5·0 | (1·3, 19·5) | 0·021 | |
| >300 to 450 | 26·5 | (9·9, 71.0) | <0·0001 | |
| >450 | 94·2 | (35·3, 251·2) | <0·0001 | |
| Mean Heart Radiation Dose | None | referent | ||
| (Gy) | >0 to 10 | 2·2 | (1·0, 4·8) | 0·050 |
| > 10 to 20 | 1·9 | (0·5, 7·3) | 0·33 | |
| > 20 to 30 | 6·1 | (1·8, 20·6) | 0·0035 | |
| > 30 | 19·7 | (7·1, 54·2) | <0·0001 | |
| *Liver wait-list registration or transplantation | ||||
| Treatment | Exposure | Hazard Ratio |
95% Confidence Interval |
p-value |
| Dactinomycin | No | 1·0 | referent | |
| Yes | 3·8 | (1·3, 11·3) | 0·016 | |
| Cyclophosphamide | No | 1·0 | referent | |
| Yes | 2·4 | (0·8, 7·5) | 0·13 | |
| IV or IM Methotrexate | No | 1·0 | referent | |
| Yes | 3·3 | (1·0, 10·2) | 0·041 | |
| Antimetabolites (6-MP or 6-TG) | No | 1·0 | referent | |
| Yes | 1·6 | (0·5, 5·1) | 0·46 | |
| Max Abdomen Tumor | None | 1·0 | referent | |
| Radiation Dose (Gy) | >0 to 20† | 0·4 | (0·1, 1·5) | 0·18 |
| > 20† | 2·2 | (0·6, 7·8) | 0·21 | |
| TBI | 2·2 | (0·3, 18·6) | 0·48 | |
| Sex | Male | 1·0 | referent | |
| Female | 0·4 | (0·2, 1·2) | 0·11 | |
| *Outcome event: first lung wait-list registration or transplantation | ||||
| Treatment factor | Level of exposure | Hazard Ratio |
95% Confidence Interval |
p-value |
| Carmustine | No | 1·0 | referent | |
| Yes | 12·3 | (3·1, 48·9) | 0·0004 | |
| IV or IM Methotrexate | No | 1·0 | referent | |
| Yes | 2·7 | (0·8, 9·9) | 0·12 | |
| Mean Lung Radiation Dose | None | 1·0 | referent | |
| (Gy) | >0 to 10 | 1·5 | (0·3, 8·3) | 0·63 |
| > 10 | 15·6 | (2·6, 92·7) | 0·0025 | |
| Age at primary cancer diagnosis | 0–4 yrs old | 9·7 | (1·0, 93·9) | 0·050 |
| 5–9 yrs old | 1·9 | (0·1, 31·3) | 0·65 | |
| 10–14 yrs old | 4·2 | (0·4, 40·5) | 0·22 | |
| 15–20 yrs old | 1·0 | referent | ||
| Sex | Male | 1·0 | referent | |
| Female | 3·3 | (0·9, 12·4) | 0·083 | |
IV – intravenous, IM – intramuscular, TBI – total body irradiation.
*
Only cancer treatment exposures associated with statistically significant increases in risk for SOT are displayed. Other factors examined include: sex, age at primary cancer diagnosis, cisplatin, cyclophosphamide and busulfan (multiple models); antimetabolites, melphalan and abdominal radiation (liver model); bleomycin and lomustine (lung model).
†
non-TBI