Current Insights into the Management of Late Chemotherapy Toxicities in Pediatric Osteosarcoma Patients
Open accessAbstract
With ever increasing long-term, disease free survival rates, long-term toxicities of otherwise successful therapy have gained increasing importance. They can be grouped into potentially life-threatening, especially secondary malignancies and anthracycline cardiomyopathies, potentially disabling, particularly severe hearing loss and renal insufficiency, other, and rare events. Pathophysiology, frequency, and medical treatment approaches are discussed. Finally, fertility issues and quality of life issues are discussed, together with an outlook into the future. The challenge to cure as many patients as possible from osteosarcoma while enabling a life free of late effects will remain.
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Secondary cancers are frequently acute myeloid leukaemias, which may be caused by previous exposure to DNA-damaging alkylators, often arising after a median of around 7 years after initial treatment.
“Secondary cancers are frequently acute myeloid leukaemias 155 , which may be caused by previous exposure to DNA-damaging alkylators, often arising after a median of around 7 years after initial treatment 158 .”
From Osteosarcoma (2022) · cites this paper as [155]
Curative osteosarcoma treatment, including anthracyclines, alkylating agents and/or topoisomerase II inhibitors, is known to cause secondary malignancies, and the risk is likely increased by individual cancer predisposition and other as yet unidentified factors.
“Curative osteosarcoma treatment, including anthracyclines, alkylating agents and/or topoisomerase II inhibitors, is known to cause secondary malignancies and the risk is likely increased by individual cancer predisposition and other as yet unidentified factors 155,157 .”
From Osteosarcoma (2022) · cites this paper as [155]
The severity of late effects may be life-threatening, severe or mild.
“The severity of these late effects may be life-threatening, severe or mild 155 .”
From Osteosarcoma (2022) · cites this paper as [155]
Both forms of secondary leukaemia have an extremely poor prognosis despite the most intensive therapies such as bone marrow transplantation.
“Both forms of secondary leukaemia have an extremely poor prognosis despite the most intensive therapies such as bone marrow transplantation 155,159 .”
From Osteosarcoma (2022) · cites this paper as [155]
The rate of treatment-related malformations does not seem to be increased in the offspring of individuals who formerly had osteosarcoma.
“The rate of treatment-related malformations does not seem to be increased in the offspring of individuals who formerly had osteosarcoma 155 .”
From Osteosarcoma (2022) · cites this paper as [155]
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Self-citation
- Authors
- Hecker-Nolting, S., Langer, T., Blattmann, C., Kager, L., & Bielack, S. S.
- Affiliations
- Olgahospital (DE)
- St Anna Children's Hospital (AT)
- University Hospital Münster (DE)
- Corresponding author
- Bielack, Stefan S
- Venue
- Cancer Management and Research
- Publisher
- Informa UK Limited
- Published
- 2021-12
- Volume
- Volume 13
- Pages
- 8989-8998
- ISSN
- 1179-1322 (ISSN-L)
- PMC
- PMC8647031
- OpenAlex
- W3216801988
- Cited by
- 10
- References
- 78
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 4
- FWCI
- 0.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cancer Management and Research (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Epidemiology › Multiple and Secondary Primary Cancers
- Keywords
- pediatric osteosarcoma, chronic toxicity, secondary malignancies, anthracycline-induced cardiomyopathy, hearing loss, renal failure, fertility preservation, quality of life, late effects of cancer treatment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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