BIRTH-DEFECTS AND CHILDHOOD-CANCER IN OFFSPRING OF SURVIVORS OF CHILDHOOD-CANCER

Objective: To determine the effect of chemotherapy for cancer during c hildhood and adolescence on subsequent pregnancy outcome and the occur rence of cancer in the offspring. Design: We reviewed the history of 4 05 former patients with pediatric cancer. A self-administered question naire was completed by members of a cohort of consecutively treated pa tients who were aged 18 years or older at the most recent follow-up vi sit and who were at least 5 years beyond the initial diagnosis of thei r cancer. Setting: Department of Pediatrics of a National Cancer Insti tute-designated comprehensive cancer center. Results: One hundred fort y-eight patients reported 280 pregnancies. Ninety-one of the patients who reported 1 or more liveborn or stillborn infants following the com pletion of treatment had received 1 or more chemotherapeutic agents as part of their treatment of cancer. The frequency of congenital anomal ies was 3.3% among the liveborn offspring of the treated women and 3.3 % among the liveborn offspring of the spouses or female companions of the treated men. No cases of childhood cancer have been diagnosed amon g the offspring. Conclusions: The present data suggest that prior trea tment with mutagenic chemotherapeutic agents, in the dosage ranges exa mined, does not increase the frequency of congenital anomalies in the offspring of former pediatric and adolescent patients with cancer. Alt hough no cases of childhood cancer have been observed thus far among t he offspring, additional follow-up is necessary to adequately assess t heir risk of childhood cancer.