Approach for classification and severity grading of long-term and late-onset health events among childhood cancer survivors in the St. Jude lifetime cohort

Melissa M. Hudson, Matthew J. Ehrhardt, Nickhill Bhakta, Malek Baassiri, Hesham Eissa, Wassim Chemaitilly, Daniel M. Green, Daniel A. Mulrooney, Gregory Armstrong, Tara M. Brinkman, James L. Klosky, Kevin R. Krull, Noah D. Sabin, Carmen L. Wilson, I. Chan Huang, Johnnie K. Bass, Karen Hale, Sue Kaste, Raja B. Khan, Deo Kumar SrivastavaYutaka Yasui, Vijaya M. Joshi, Saumini Srinivasan, Dennis Stokes, Mary Ellen Hoehn, Matthew Wilson, Kirsten K. Ness, Leslie L. Robison

Research output: Contribution to journalReview article

35 Citations (Scopus)

Abstract

Characterization of toxicity associated with cancer and its treatment is essential to quantify risk, inform optimization of therapeutic approaches for newly diagnosed patients, and guide health surveillance recommendations for long-term survivors. The NCI Common Terminology Criteria for Adverse Events (CTCAE) provides a common rubric for grading severity of adverse outcomes in cancer patients that is widely used in clinical trials. The CTCAE has also been used to assess late cancer treatment-related morbidity but is not fully representative of the spectrum of events experienced by pediatric and aging adult survivors of childhood cancer. Also, CTCAE characterization does not routinely integrate detailed patientreported and medical outcomes data available from clinically assessed cohorts. To address these deficiencies, we standardized the severity grading of long-term and late-onset health events applicable to childhood cancer survivors across their lifespan by modifying the existing CTCAE v4.03 criteria and aligning grading rubrics from other sources for chronic conditions not included or optimally addressed in the CTCAE v4.03. This article describes the methods of late toxicity assessment used in the St. Jude Lifetime Cohort Study, a clinically assessed cohort in which data from multiple diagnostic modalities and patient-reported outcomes are ascertained.

Original languageEnglish (US)
Pages (from-to)666-674
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Volume26
Issue number5
DOIs
StatePublished - May 1 2017

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Terminology
Survivors
Health
Neoplasms
Second Primary Neoplasms
Cohort Studies
Clinical Trials
Pediatrics
Morbidity
Therapeutics

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology

Cite this

Approach for classification and severity grading of long-term and late-onset health events among childhood cancer survivors in the St. Jude lifetime cohort. / Hudson, Melissa M.; Ehrhardt, Matthew J.; Bhakta, Nickhill; Baassiri, Malek; Eissa, Hesham; Chemaitilly, Wassim; Green, Daniel M.; Mulrooney, Daniel A.; Armstrong, Gregory; Brinkman, Tara M.; Klosky, James L.; Krull, Kevin R.; Sabin, Noah D.; Wilson, Carmen L.; Huang, I. Chan; Bass, Johnnie K.; Hale, Karen; Kaste, Sue; Khan, Raja B.; Srivastava, Deo Kumar; Yasui, Yutaka; Joshi, Vijaya M.; Srinivasan, Saumini; Stokes, Dennis; Hoehn, Mary Ellen; Wilson, Matthew; Ness, Kirsten K.; Robison, Leslie L.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 26, No. 5, 01.05.2017, p. 666-674.

Research output: Contribution to journalReview article

Hudson, MM, Ehrhardt, MJ, Bhakta, N, Baassiri, M, Eissa, H, Chemaitilly, W, Green, DM, Mulrooney, DA, Armstrong, G, Brinkman, TM, Klosky, JL, Krull, KR, Sabin, ND, Wilson, CL, Huang, IC, Bass, JK, Hale, K, Kaste, S, Khan, RB, Srivastava, DK, Yasui, Y, Joshi, VM, Srinivasan, S, Stokes, D, Hoehn, ME, Wilson, M, Ness, KK & Robison, LL 2017, 'Approach for classification and severity grading of long-term and late-onset health events among childhood cancer survivors in the St. Jude lifetime cohort', Cancer Epidemiology Biomarkers and Prevention, vol. 26, no. 5, pp. 666-674. https://doi.org/10.1158/1055-9965.EPI-16-0812
Hudson, Melissa M. ; Ehrhardt, Matthew J. ; Bhakta, Nickhill ; Baassiri, Malek ; Eissa, Hesham ; Chemaitilly, Wassim ; Green, Daniel M. ; Mulrooney, Daniel A. ; Armstrong, Gregory ; Brinkman, Tara M. ; Klosky, James L. ; Krull, Kevin R. ; Sabin, Noah D. ; Wilson, Carmen L. ; Huang, I. Chan ; Bass, Johnnie K. ; Hale, Karen ; Kaste, Sue ; Khan, Raja B. ; Srivastava, Deo Kumar ; Yasui, Yutaka ; Joshi, Vijaya M. ; Srinivasan, Saumini ; Stokes, Dennis ; Hoehn, Mary Ellen ; Wilson, Matthew ; Ness, Kirsten K. ; Robison, Leslie L. / Approach for classification and severity grading of long-term and late-onset health events among childhood cancer survivors in the St. Jude lifetime cohort. In: Cancer Epidemiology Biomarkers and Prevention. 2017 ; Vol. 26, No. 5. pp. 666-674.
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T1 - Approach for classification and severity grading of long-term and late-onset health events among childhood cancer survivors in the St. Jude lifetime cohort

AU - Hudson, Melissa M.

AU - Ehrhardt, Matthew J.

AU - Bhakta, Nickhill

AU - Baassiri, Malek

AU - Eissa, Hesham

AU - Chemaitilly, Wassim

AU - Green, Daniel M.

AU - Mulrooney, Daniel A.

AU - Armstrong, Gregory

AU - Brinkman, Tara M.

AU - Klosky, James L.

AU - Krull, Kevin R.

AU - Sabin, Noah D.

AU - Wilson, Carmen L.

AU - Huang, I. Chan

AU - Bass, Johnnie K.

AU - Hale, Karen

AU - Kaste, Sue

AU - Khan, Raja B.

AU - Srivastava, Deo Kumar

AU - Yasui, Yutaka

AU - Joshi, Vijaya M.

AU - Srinivasan, Saumini

AU - Stokes, Dennis

AU - Hoehn, Mary Ellen

AU - Wilson, Matthew

AU - Ness, Kirsten K.

AU - Robison, Leslie L.

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N2 - Characterization of toxicity associated with cancer and its treatment is essential to quantify risk, inform optimization of therapeutic approaches for newly diagnosed patients, and guide health surveillance recommendations for long-term survivors. The NCI Common Terminology Criteria for Adverse Events (CTCAE) provides a common rubric for grading severity of adverse outcomes in cancer patients that is widely used in clinical trials. The CTCAE has also been used to assess late cancer treatment-related morbidity but is not fully representative of the spectrum of events experienced by pediatric and aging adult survivors of childhood cancer. Also, CTCAE characterization does not routinely integrate detailed patientreported and medical outcomes data available from clinically assessed cohorts. To address these deficiencies, we standardized the severity grading of long-term and late-onset health events applicable to childhood cancer survivors across their lifespan by modifying the existing CTCAE v4.03 criteria and aligning grading rubrics from other sources for chronic conditions not included or optimally addressed in the CTCAE v4.03. This article describes the methods of late toxicity assessment used in the St. Jude Lifetime Cohort Study, a clinically assessed cohort in which data from multiple diagnostic modalities and patient-reported outcomes are ascertained.

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