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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention

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Review

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 T. 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 Srivastava, Yutaka Yasui, Vijaya M. Joshi, Saumini Srinivasan, Dennis Stokes, Mary Ellen Hoehn, Matthew Wilson, Kirsten K. Ness and Leslie L. Robison
Melissa M. Hudson
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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  • For correspondence: melissa.hudson@stjude.org
Matthew J. Ehrhardt
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Nickhill Bhakta
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Global Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Malek Baassiri
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Hesham Eissa
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Wassim Chemaitilly
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Daniel M. Green
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Daniel A. Mulrooney
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Gregory T. Armstrong
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Tara M. Brinkman
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.
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James L. Klosky
Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Kevin R. Krull
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Noah D. Sabin
Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Carmen L. Wilson
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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I-Chan Huang
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Johnnie K. Bass
Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Karen Hale
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Sue Kaste
Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Raja B. Khan
Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Deo Kumar Srivastava
Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Yutaka Yasui
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Vijaya M. Joshi
University of Tennessee College of Medicine, Memphis, Tennessee.
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Saumini Srinivasan
University of Tennessee College of Medicine, Memphis, Tennessee.
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Dennis Stokes
University of Tennessee College of Medicine, Memphis, Tennessee.
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Mary Ellen Hoehn
University of Tennessee College of Medicine, Memphis, Tennessee.
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Matthew Wilson
University of Tennessee College of Medicine, Memphis, Tennessee.
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Kirsten K. Ness
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Leslie L. Robison
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
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DOI: 10.1158/1055-9965.EPI-16-0812 Published May 2017
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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 patient-reported 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. Cancer Epidemiol Biomarkers Prev; 26(5); 666–74. ©2016 AACR.

This article is featured in Highlights of This Issue, p. 661

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Received October 12, 2016.
  • Revision received November 28, 2016.
  • Accepted December 15, 2016.
  • ©2016 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 26 (5)
May 2017
Volume 26, Issue 5
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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 T. 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 Srivastava, Yutaka Yasui, Vijaya M. Joshi, Saumini Srinivasan, Dennis Stokes, Mary Ellen Hoehn, Matthew Wilson, Kirsten K. Ness and Leslie L. Robison
Cancer Epidemiol Biomarkers Prev May 1 2017 (26) (5) 666-674; DOI: 10.1158/1055-9965.EPI-16-0812

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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 T. 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 Srivastava, Yutaka Yasui, Vijaya M. Joshi, Saumini Srinivasan, Dennis Stokes, Mary Ellen Hoehn, Matthew Wilson, Kirsten K. Ness and Leslie L. Robison
Cancer Epidemiol Biomarkers Prev May 1 2017 (26) (5) 666-674; DOI: 10.1158/1055-9965.EPI-16-0812
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