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Blood, 1 April 2004, Vol. 103, No. 7, pp. 2460-2466. Prepublished online as a Blood First Edition Paper on December 18, 2003; DOI 10.1182/blood-2003-07-2565. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-07-2565v1 103/7/2460    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Castellino, S. Articles by Hudson, M. M. Search for Related Content PubMed PubMed Citation Articles by Castellino, S. Articles by Hudson, M. M. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS The epidemiology of chronic hepatitis C infection in survivors of childhood cancer: an update of the St Jude Children's Research Hospital hepatitis C seropositive cohort Sharon Castellino, Shelly Lensing, Caroline Riely, Shesh N. Rai, Rene Davila, Randall T. Hayden, Jackie Fleckenstein, Mark Levstik, Shari Taylor, Patrick J. Dean, Sarah Kippenbrock, Jennifer Pope, Jeanne Carr, Donald K. Strickland, and Melissa M. Hudson From the Departments of Hematology-Oncology, Pathology, and Biostatistics, St Jude Children's Research Hospital; the Departments of Medicine and Pediatrics, University of Tennessee Health Science Center; and the G.I. Pathology Partners, Memphis, TN. Childhood cancer survivors transfused before 1992 are at risk for chronic hepatitis C (HCV) infection. In 1995, St Jude Children's Research Hospital initiated an epidemiologic study of childhood cancer survivors with transfusion-acquired HCV. Of the 148 survivors with HCV confirmed by second-generation enzyme immunoassay, 122 consented to participate in the study. Their current median age is 29 years (range, 9 to 47 years). At enrollment, polymerase chain reaction (PCR) testing indicated chronic infection in 81.1%; genotype 1 was the most common viral genotype. Liver biopsy in 60 patients at a median of 12.4 years from the diagnosis of malignancy showed mild (28.8%) or moderate (35.6%) fibrosis; 13.6% had cirrhosis. Elevated body mass index was associated with histologic findings of increased steatosis (P = .008). Antimetabolite chemotherapy exposure was associated with early progression of fibrosis. Significant quality-of-life deficits were observed in noncirrhotic adult survivors. Antiviral therapy resulted in clearance of infection in 17 (44%) of 38 patients to date. Six patients have died; 1 patient with decompensated cirrhosis died of variceal bleeding. Despite a young age at HCV infection, the progression of liver disease in childhood cancer survivors is comparable to that seen in adults. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. D. Dickerman The Late Effects of Childhood Cancer Therapy Pediatrics, March 1, 2007; 119(3): 554 - 568. [Abstract] [Full Text] [PDF] A. Tichelli and G. Socie Considerations for Adult Cancer Survivors Hematology, January 1, 2005; 2005(1): 516 - 522. [Abstract] [Full Text] [PDF] K. C. Oeffinger and M. M. Hudson Long-term Complications Following Childhood and Adolescent Cancer: Foundations for Providing Risk-based Health Care for Survivors CA Cancer J Clin, July 1, 2004; 54(4): 208 - 236. [Abstract] [Full Text] [PDF]

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