Incidence and Clinical Relevance of Abnormal Complete Blood Counts in Survivors of Childhood Cancer

dc.contributor.advisorOeffinger, Kevin C.en
dc.creatorLong, Zsofia Banhegyien
dc.date.accessioned2010-07-12T17:23:38Z
dc.date.available2010-07-12T17:23:38Z
dc.date.issued2005-03-21
dc.description.abstractBACKGROUND: The purpose of this study was to determine the incidence and clinical significance of abnormal complete blood counts (CBCs) obtained during follow-up of childhood cancer survivors. METHODS: A retrospective cohort study was conducted on 193 survivors, diagnosed between 1970-1986, who have been followed in our center's After Cancer Experience Program and are participants in the Childhood Cancer Survivor Study. Of these patients, 49% were female and 25% were racial/ethnic minorities. The primary outcome was determination of the cumulative percentage of patients having an abnormal CBC by 2 or 3 standard deviations (SDs). Four components of the CBC were examined and employed to define an abnormal CBC: low white blood cell count (WBC), high mean corpuscular volume (MCV), low platelet count, and low hemoglobin concentration. Association of treatment exposures to abnormal values was assessed with a multi-level logistic model. RESULTS: There were 1,376 patient visits during 1,437 person-years of follow-up. The mean number of visits per survivor was 7.2 (SD 4.5). The cumulative percentage of subjects with at least one abnormal CBC was 70%. The cumulative percent of subjects with a value abnormal by 2 SD was WBC=23%, MCV=33%, platelets=9%, hemoglobin=49%. For values abnormal by 3 SD, the frequencies were WBC=3%, MCV=18%, platelets=1%, hemoglobin=27%. None of the patients developed myelodysplastic syndrome or a secondary leukemia during the follow-up period. Exposure to epipodophyllotoxins was associated with an increased risk of having abnormally high MCV values. CONCLUSIONS: Mildly abnormal CBC values are common in survivors of childhood cancer. Abnormal values are often of questionable significance but seem to persist over time. Epipodophyllotoxin therapy was found to be associated with increased frequency of high MCV levels.en
dc.format.digitalOriginborn digitalen
dc.format.mediumElectronicen
dc.format.mimetypeapplication/pdfen
dc.identifier.oclc59007235
dc.identifier.urihttps://hdl.handle.net/2152.5/272
dc.language.isoenen
dc.subjectEpidemiologic Studiesen
dc.subjectBlood Cell Counten
dc.subjectEpipodophyllotoxinen
dc.titleIncidence and Clinical Relevance of Abnormal Complete Blood Counts in Survivors of Childhood Canceren
dc.typeThesisen
dc.type.genredissertationen
dc.type.materialTexten
thesis.date.available2005-03-21
thesis.degree.departmentUT Southwestern Medical Schoolen
thesis.degree.disciplineResearchen
thesis.degree.grantorUT Southwestern Medical Centeren
thesis.degree.levelDoctoralen
thesis.degree.nameM.D. with Distinctionen

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
longzsofia.pdf
Size:
306.48 KB
Format:
Adobe Portable Document Format

License bundle

Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
941 B
Format:
Item-specific license agreed upon to submission
Description: