Publications by authors named "Leisenring W"
Temporal Trends of Subsequent CNS Malignancies Among Survivors of Childhood Cancer.
J Natl Cancer Inst
January 2025
Purpose: It is not known whether temporal changes in childhood cancer therapy have reduced risk of subsequent malignant neoplasms (SMNs) of the central nervous system (CNS), a frequently fatal late effect of cancer therapy.
Methods: Five-year survivors of primary childhood cancers diagnosed between 1970-1999 in the Childhood Cancer Survivor Study with a subsequent CNS SMN were identified. Cumulative incidence rates and standardized incidence ratios (SIR) were compared among survivors diagnosed between 1970-1979 (N = 6223), 1980-1989 (N = 9680), and 1990-1999 (N = 8999).
Purpose: Melanoma as a subsequent malignant neoplasm has been described among childhood cancer survivors; however, the risk factors and long-term survival are not well understood.
Methods: We assessed incidence, risk factors, and outcomes for melanoma among participants in the Childhood Cancer Survivor Study cohort. Cumulative incidence and standardized incidence ratios (SIRs) were calculated, and multivariable Cox models were used to determine hazard ratios (HRs) and associated 95% CI for melanoma risk factors.
Background: Adolescents and young adults with cancer (AYAs, ages 15-39 at the time of diagnosis) experience significant adverse health and psychosocial outcomes. AYAs live with emotional distress and health care demands that exceed those of their healthy peers but can have difficulty accessing care. Digitally delivered interventions are an attractive option for AYA survivors, a population that routinely utilizes online resources when seeking health information and support.
View Article and Find Full Text PDFBackground: While female survivors of Hodgkin lymphoma (HL) have an increased risk of breast cancer (BC), no BC risk prediction model is available. We developed such models incorporating mean radiation dose to the breast or breast quadrant-specific radiation doses.
Methods: Relative risks and age-specific incidence for BC and competing events (mortality or other subsequent cancer) were estimated from 1194 Dutch five-year HL survivors, treated at ages 11-40 during 1965-2000.
Article Synopsis
- Many childhood cancer survivors are at risk for cardiovascular issues and should receive carotid ultrasounds, especially 10 years post neck radiation therapy of 40 Gy or more, according to guidelines.
- A study examined nearly 10,000 childhood cancer survivors, revealing that only 29.7% of those who had high-dose neck radiation had a carotid ultrasound, compared to 10.7% of those who had lower doses and just 4.7% of siblings without cardiovascular conditions.
- Factors like being over 50, recent visits to a cancer specialist, and undergoing other tests, like colonoscopies or echocardiograms, increase the likelihood of having a carotid ultrasound among these survivors.
Article Synopsis
- Researchers investigated how machine learning could improve predicting cardiomyopathy risk in childhood cancer survivors using echocardiograms from multiple centers.
- They designed deep convolutional neural networks (DCNNs) to analyze different sets of echocardiographic data and gauge model performance using standard metrics like F1-score and AUPRC.
- Results showed that the DCNN effectively distinguished between survivors who developed cardiomyopathy and those who didn't, suggesting a potential tool for early prediction in at-risk patients.
Article Synopsis
- Many adult survivors of childhood cancer worry about their cancer coming back, which can make them feel really stressed and affect their everyday life.
- A study looked at how common this fear is among people who survived childhood cancer and what makes it worse.
- They found that about 17% of these survivors have a strong fear of cancer returning and that this fear is linked to being unemployed and having certain health issues.
Introduction: Continuity and coordination-of-care for childhood cancer survivors with multiple chronic conditions are understudied but critical for appropriate follow-up care.
Methods: From April through June 2022, 800 Childhood Cancer Survivor Study participants with two or more chronic conditions (one or more severe/life-threatening/disabling) were emailed the "Patient Perceived Continuity-of-Care from Multiple Clinicians" survey. The survey asked about survivors' main (takes care of most health care) and coordinating (ensures follow-up) provider, produced three care-coordination summary scores (main provider, across multiple providers, patient-provider partnership), and included six discontinuity indicators (e.
Background: Interventions to increase physical activity are needed in adolescent and young adult survivors of childhood cancer who are largely inactive but at lifelong elevated risk of multiple chronic conditions improved by physical activity. The goals of the StepByStep study are to evaluate the effects of a 48-week distance-based, multi-component mobile health and social media behavioral intervention on physical activity, biomarkers of cardiometabolic health, and health-related quality of life.
Methods: This ongoing study is a two-arm, prospective, multi-site randomized controlled trial.
Although survivors of childhood cancer are at an increased risk, little is known about the prevalence of chronic pain, associated interference, and daily pain experiences. Survivors (N = 233; mean age = 40.8 years, range 22-64 years; mean time since diagnosis = 32.
View Article and Find Full Text PDFBackground: Treatment of childhood medulloblastoma has evolved to reduce neurotoxicity while improving survival. However, the impact of evolving therapies on late neurocognitive outcomes and adult functional independence remains unknown.
Methods: Adult survivors of childhood medulloblastoma (n = 505; median [minimum-maximum] age, 29 [18-46] years) and sibling controls (n = 727; 32 [18-58] years) from the Childhood Cancer Survivor Study completed surveys assessing neurocognitive problems and chronic health conditions (CHCs).
Article Synopsis
- Cytomegalovirus (CMV) disease can occur before hematopoietic cell transplantation (HCT) and negatively affect post-transplant outcomes, but the effects of reactivation prior to the procedure were previously unclear.
- A study found that 11% of HCT candidates experienced pre-HCT CMV reactivation, with lymphopenia identified as a strong risk factor.
- The presence of pre-HCT CMV reactivation was linked to higher risks of further reactivation and related diseases within the first year after HCT, supporting the need for regular surveillance and potential antiviral therapy in high-risk patients.
Background: Approximately 1 in 10 adult survivors of childhood cancer is underweight. Although the consequences of being overweight or obese have been well described, outcomes among childhood cancer survivors who are underweight are unknown.
Objective: To determine whether underweight status increases the risk of mortality.
Health insurance among survivors of childhood cancer following Affordable Care Act implementation.
J Natl Cancer Inst
September 2024
Background: The Affordable Care Act (ACA) increased private nonemployer health insurance options, expanded Medicaid eligibility, and provided preexisting health condition protections. We evaluated insurance coverage among long-term adult survivors of childhood cancer pre- and post-ACA implementation.
Methods: Using the multicenter Childhood Cancer Survivor Study, we included participants from 2 cross-sectional surveys: pre-ACA (2007-2009; survivors: n = 7505; siblings: n = 2175) and post-ACA (2017-2019; survivors: n = 4030; siblings: n = 987).
Background: The impact of adverse childhood experiences (ACE, e.g., abuse, neglect, and/or household dysfunction experienced before the age of 18) and resilience on risk for cardiovascular disease (CVD) has not previously been investigated in adult survivors of childhood cancer.
View Article and Find Full Text PDFImportance: Employment is an important factor in quality of life and provides social and economic support. Longitudinal data on employment and associations with chronic health conditions for adult survivors of childhood cancer are lacking.
Objective: To evaluate longitudinal trends in employment among survivors of childhood cancer.
Background: Long-term survivors of childhood cancer face elevated risk for financial hardship. We evaluate whether childhood cancer survivors live in areas of greater deprivation and the association with self-reported financial hardships.
Methods: We performed a cross-sectional analysis of data from the Childhood Cancer Survivor Study between 1970 and 1999 and self-reported financial information from 2017 to 2019.
Background: Pretransplant respiratory virus (RV) infections have been associated with negative transplant outcomes in adult hematopoietic cell transplantation (HCT) recipients. In the era of HCT delay because of high-risk RVs, we examined the impact of pretransplant RV detection on transplant outcomes in pediatric HCT recipients.
Methods: This retrospective cohort study included pediatric myeloablative allogeneic HCT recipients from 2010 to 2019.
Article Synopsis
- - Preemptive therapy (PET) and letermovir prophylaxis are effective in preventing cytomegalovirus (CMV) disease in the first 100 days after hematopoietic cell transplantation but can lead to late-onset CMV disease among survivors.
- - A study of 2469 day 100 survivors revealed a 7.2% incidence of late CMV disease, with similar risks between PET and letermovir groups, and factors like posttransplant cyclophosphamide and steroid use linked to increased risk.
- - Late CMV disease often arises from prolonged low-level viremia and is associated with higher mortality, highlighting the need for better prevention strategies in post-transplant care.
Purpose: Childhood cancer survivors are at increased risk for underinsurance and health insurance-related financial burden. Interventions targeting health insurance literacy (HIL) to improve the ability to understand and use health insurance are needed.
Methods: We codeveloped a four-session health insurance navigation tools (HINT) intervention, delivered synchronously by a patient navigator, and a corresponding booklet.
Background: Early efforts at risk-adapted therapy for neuroblastoma are predicted to result in differential late effects; the magnitude of these differences has not been well described.
Methods: Late mortality, subsequent malignant neoplasms (SMNs), and severe/life-threatening chronic health conditions (CHCs), graded according to CTCAE v4.03, were assessed among 5-year Childhood Cancer Survivor Study (CCSS) survivors of neuroblastoma diagnosed 1987-1999.
Survivors of childhood cancer are at increased risk for subsequent cancers attributable to the late effects of radiotherapy and other treatment exposures; thus, further understanding of the impact of genetic predisposition on risk is needed. Combining genotype data for 11,220 5-year survivors from the Childhood Cancer Survivor Study and the St Jude Lifetime Cohort, we found that cancer-specific polygenic risk scores (PRSs) derived from general population, genome-wide association study, cancer loci identified survivors of European ancestry at increased risk of subsequent basal cell carcinoma (odds ratio per s.d.
View Article and Find Full Text PDFPediatric glioma therapy has evolved to delay or eliminate radiation for low-grade tumors. This study examined these temporal changes in therapy with long-term outcomes in adult survivors of childhood glioma. Among 2,501 5-year survivors of glioma in the Childhood Cancer Survivor Study diagnosed 1970-1999, exposure to radiation decreased over time.
View Article and Find Full Text PDFBackground: Prevalence and risk of poor psychological outcomes following rhabdomyosarcoma (RMS) are not well-established.
Methods: Participants in this cross-sectional, case-control study (n = 713 survivors, 42.5% female; mean [SD] age, 30.