Table 2.
Results summary: overview of identified late effects, reported frequency, time to onset, and risk factors.
| LATE EFFECTS (Number of studies) |
DRUG CLASS | NUMBER OF PATIENTS IMPACTED | INCIDENCE/ PREVALENCE | TIME TO ONSET | RISK FACTORS | |
|---|---|---|---|---|---|---|
| Cardiac toxicity (N = 14) |
Heart failure | ATC | High | 1.7% at 5 yrs* to 68.1% at 17.3 yrs^ |
NR | Dose, age, homozygous for the CBR3 V244M G allele, Hodgkin’s lymphoma, Non-Hodgkin’s lymphoma, hypertension |
| Abnormal echocardiogram | ATC | High | 14.7% at 15.8 yrs* to 35% at 8 yrs* |
1 yr* | ||
| Valvular disease | ATC | High | 1.5% by 45 yrs of age to 28% at 22.6 yrs^ |
NR | ||
| Structure and function disorder | ATC | High | 1.3% by 45 yrs of age to 48% at 28 yrs^ |
NR | ||
| Cardiomyopathy | ATC | Low | 5% at 10 yrs^ to 7.4% at 22.6 yrs^ |
NR | ||
| Artery disease | ATC | Low | 3.8% at 22.6 yrs^ to 5.3% by 45 yrs of age |
NR | ||
| Hormone deficiencies, infertility (N = 14) |
Male | ALK | High | 50% at 4.9 yrs* to 60% at 3.32 yrs* |
NR | Dose, age, radiation use, Hodgkin’s lymphoma, non-Hodgkin’s lymohoma |
| Female | ALK | High | 7.6% NR to 83% at 4.9 yrs* |
NR | ||
| Secondary leukemia (N = 7) |
t-MDS/AML | ATC ALK |
Moderate | 0.3% at 30 yrs* to 11% at 5 yrs* |
2.6 to 4.4 yrs* | Dose, Hodgkin’s lymphoma |
| Osteonecrosis (N = 6) |
Avascular necrosis | CTS | Low | 0.43% at 20 yrs* to 9.7% at 6 months^ |
1.8 to 2.4 yrs* | Dose, age, sex, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma |
| Urotoxicity, bladder malignancy (N = 4) |
Hemorrhagic cystitis | ALK | NR | NR | NR | Dose, radiotherapy |
| Bladder cancer | ALK | Moderate | 0.5% at 8.5yrs* to 10.7% at 12 yrs* |
5 to 8.5 yrs* | ||
*=after treatment; ^=after diagnosis; AML, acute myeloid leukemia; ATC, anthracycline; AMT, antimicrotubular; ALK, alkylating agents; CTS, corticosteroids; NR, not reported; yr(s), years. High ≥20% of patients affected; Moderate = 10–20% of patients affected; Low ≤10% of patients affected.