Chemo Appears Not To Raise Birth Defect Risk in Offspring

BUFFALO, NY--Despite a history of aggressive chemotherapy, survivorsof childhood cancer are capable of conceiving and giving birthto healthy children, Daniel M. Green, MD, of the Department ofPediatrics, Roswell Park Cancer Institute, said at the 4th InternationalConference on Long-Term Complications of Children and Adolescentsfor Cancer.

A Questionnaire

In their study, Dr. Green and his colleagues asked 5-year survivorswho were over 18 years of age to complete a questionnaire regardingpregnancy outcome and health of offspring.

A total of 280 pregnancies were reported by 148 of the 405 respondentsto the questionnaire. Of the 91 patients (37 males, 54 females)who had received one or more chemotherapeutic agents, 153 pregnancieswere reported: 142 full-term, 10 premature, and 1 stillborn.

The frequency of birth defects, using the Metropolitan AtlantaCongenital Defects Program definition, was 3.3%, a frequency thatis similar statistically to that documented for the entire USpopulation, Dr. Green said.

None of the survivors reported having had a child diagnosed withcancer. "Although the follow-up data tend to support ourbelief that offspring do not have an increased risk of developingcancer, we continue to adopt a 'so far, so good' approach,"he said.

Offspring Are Still Young

The offspring are still young. "The majority have not reachedthe age when their parent (median age of 13 for both sexes) wasdiagnosed with childhood cancer," Dr. Green said. "We'dlike to see these same healthy children reach and surpass thatage before we confidently dismiss the possibility of an increasedrisk of childhood cancer in the offspring."

Dr. Green's colleagues on this study were Albert Fiorello, ofSUNY-Buffalo, and Michael Zevon, PhD, Brenda Hall, RN, GeoffreyLowrie, MA, and Nina Siegelstein, of Roswell Park. The conferencewas co-sponsored by Bristol-Myers Squibb Oncology and the NCI

Sidebar

Long-Term Follow-up Clinic for Pediatric Cancer Patients

Since 1986, pediatric oncologists at Roswell Park Cancer Centerhave maintained long-term follow-up of pediatric cancer patientsand their offspring through the Long-term Follow-up Clinic, ofwhich Dr. Daniel Green is the director (see article above).

Such monitoring is needed for two reasons, Dr. Green said: First,to determine if there is a genetic risk involved with childhoodcancers and second, to determine if former patients are more susceptibleto developing other malignancies or "second cancers"as they grow older.

The clinic also provides specialized medical care and counselingto former childhood cancer patients, he said.

Such counseling helps patients deal with problems unique to theirsituation, including difficulty in finding employment or obtaininghealth insurance, concerns about reproductive capability, andthe possibility of developing other cancers later in life.