TABLE 2.
Common or serious late effects by organ system and therapeutic exposure
| Organ system/domain (late effect) | Therapeutic exposure* |
|---|---|
| Brain (neurocognitive deficits) | Methotrexate (intrathecal, high dose intravenous), cytarabine (high dose intravenous) |
| Eye (cataract) | Busulfan, glucocorticoids (e.g., dexamethasone, prednisone) |
| Ear (hearing loss) | Carboplatin (myeloablative doses), cisplatin |
| Peripheral nervous system (neuropathy) | Carboplatin, cisplatin, vinblastine, vincristine |
| Dental (aplasia, dysplasia, hypoplasia) | Any chemotherapy |
| Heart (cardiomyopathy) | Anthracyclincs (i.e., doxorubicin, daunorubicin, epirubicin, idarubicin), anthraquinone (mitoxantrone) |
| Lung (interstitial pneumonitis, fibrosis) | Bleomycin, busulfan, carmustine, lomustine |
| Liver (hepatic dysfunction) | Antimetabolites (i.e., mercaptopurine, methotrexate, thioguanine) |
| Kidney (renal insufficiency) | Ifosfamide |
| Gonads (primary hypogonadism) | Alkylating agents (e.g., cyclophosphamide, ifosfamide, busulfan, carmustine, lomustine, melphalan, procarbazine, thiotepa) |
| Bone (osteopenia) | Glucocorticoids, methotrexate |
| Secondary malignancy (acute myeloid leukemia, myelodysplasia) | Anthracyclines, alkylating agents, epipodophyllotoxins (i.e., etoposide, teniposide) |
| Mental health (anxiety, depression, post-traumatic stress) | Any cancer experience |
*
Radiation to a given area is associated with late effects to the affected organ system, including endocrinopathies (e.g., hypothyroidism, hypogonadism, diabetes), growth and development (e.g., fibrosis, hypoplasia, neurocognitive impairment), premature aging (e.g., atherosclerosis), and second cancers.