Demographic and treatment characteristics
| Characteristic . | Survivors (n = 1760) . | Siblings (n = 3180) . | P* . |
|---|---|---|---|
| Female sex | 916 (52.1%) | 1733 (54.5%) | .0934 |
| White | 1615 (91.8%) | 2916 (91.7%) | .7681 |
| Age at follow-up, median (minimum, maximum), y | 37.0 (21.0-54.0) | 33.0 (18.0, 58.0) | <.001 |
| Smoking status† | |||
| Never | 1195 (67.9%) | 1913 (60.2%) | <.001 |
| Former | 349 (19.8%) | 668 (21.0%) | |
| Current | 216 (12.3%) | 599 (18.8%) | |
| Meet CDC physical activity recommendations‡ | 1096 (62.3%) | 2119 (66.6%) | .003 |
| Age at diagnosis, median (minimum, maximum), y | 14.00 (2.00, 20.00) | — | — |
| Time since diagnosis, median (minimum, maximum), y | 23.15 (14.73, 34.25) | — | — |
| Treatment group§ | |||
| High-risk relapse or transplant | 137 (7.8%) | ||
| High-risk RT only (extended field) | 348 (19.8%) | ||
| High-risk combined modality | 148 (8.4%) | ||
| High-risk chest RT only | 137 (7.8%) | ||
| Intermediate-risk combined group A | 238 (13.5%) | ||
| Intermediate-risk combined group B | 173 (9.8%) | ||
| Low risk | 133 (7.6%) | ||
| Other | 177 (10.1%) | ||
| Chemotherapy exposures | |||
| Anthracyclineǁ | 700 (43.4%) | ||
| Median dose mg/m2 (IQR) | 198.4 (103.7) | ||
| Cyclophosphamide equivalent dose¶ | 1039 (59.0) | ||
| Median dose mg/m2 (IQR) | 8183.2 (5849.0) | ||
| IV methotrexate# | 103 (6.2%) | ||
| Bleomycin** | 589 (35.8%) | ||
| Corticosteroids†† | 956 (58.1%) | ||
| Radiation exposures | |||
| Chest radiation‡‡ | |||
| 0 Gya | 339 (20.9%) | ||
| ≤30 Gy | 497 (30.6%) | ||
| >30 Gy | 788 (48.5%) | ||
| Neck radiationb | |||
| 0 Gya | 283 (17.4%) | ||
| ≤30 Gy | 562 (34.6%) | ||
| >30 Gy | 780 (48.0%) | ||
| Late relapse (≥5 y postdiagnosis) | 52 (3.0%) | ||
| Subsequent malignancy (≥5 y postdiagnosis) | 1447 (82.2%) |
| Characteristic . | Survivors (n = 1760) . | Siblings (n = 3180) . | P* . |
|---|---|---|---|
| Female sex | 916 (52.1%) | 1733 (54.5%) | .0934 |
| White | 1615 (91.8%) | 2916 (91.7%) | .7681 |
| Age at follow-up, median (minimum, maximum), y | 37.0 (21.0-54.0) | 33.0 (18.0, 58.0) | <.001 |
| Smoking status† | |||
| Never | 1195 (67.9%) | 1913 (60.2%) | <.001 |
| Former | 349 (19.8%) | 668 (21.0%) | |
| Current | 216 (12.3%) | 599 (18.8%) | |
| Meet CDC physical activity recommendations‡ | 1096 (62.3%) | 2119 (66.6%) | .003 |
| Age at diagnosis, median (minimum, maximum), y | 14.00 (2.00, 20.00) | — | — |
| Time since diagnosis, median (minimum, maximum), y | 23.15 (14.73, 34.25) | — | — |
| Treatment group§ | |||
| High-risk relapse or transplant | 137 (7.8%) | ||
| High-risk RT only (extended field) | 348 (19.8%) | ||
| High-risk combined modality | 148 (8.4%) | ||
| High-risk chest RT only | 137 (7.8%) | ||
| Intermediate-risk combined group A | 238 (13.5%) | ||
| Intermediate-risk combined group B | 173 (9.8%) | ||
| Low risk | 133 (7.6%) | ||
| Other | 177 (10.1%) | ||
| Chemotherapy exposures | |||
| Anthracyclineǁ | 700 (43.4%) | ||
| Median dose mg/m2 (IQR) | 198.4 (103.7) | ||
| Cyclophosphamide equivalent dose¶ | 1039 (59.0) | ||
| Median dose mg/m2 (IQR) | 8183.2 (5849.0) | ||
| IV methotrexate# | 103 (6.2%) | ||
| Bleomycin** | 589 (35.8%) | ||
| Corticosteroids†† | 956 (58.1%) | ||
| Radiation exposures | |||
| Chest radiation‡‡ | |||
| 0 Gya | 339 (20.9%) | ||
| ≤30 Gy | 497 (30.6%) | ||
| >30 Gy | 788 (48.5%) | ||
| Neck radiationb | |||
| 0 Gya | 283 (17.4%) | ||
| ≤30 Gy | 562 (34.6%) | ||
| >30 Gy | 780 (48.0%) | ||
| Late relapse (≥5 y postdiagnosis) | 52 (3.0%) | ||
| Subsequent malignancy (≥5 y postdiagnosis) | 1447 (82.2%) |
IQR, interquartile range; RT, radiation therapy.
P values based on GEE that took into account the familial correlation between survivors and control subjects.
Current smokers: at least 100 cigarettes in their lifetime and current smoking; former smokers: 100 cigarettes and no current smoking.
Defined as at least 7.5 metabolic equivalent of task hours of physical activity per week.
Treatment classification based on Oeffinger et al18 in which the high-risk relapse/transplant group included any survivor with a relapse or auto/allogeneic transplant ≤5 years postdiagnosis, the high-risk RT only group includes those with chest RT ≥ 35 Gy and abdominal or pelvic RT ≥ 35 Gy, high-risk combined modality included those with chest RT ≥ 35 Gy plus anthracyclines or cyclophosphamide-equivalent dose (CED), high-risk chest RT only included those with chest RT ≥ 35 Gy without any anthracycline or CED, intermediate-risk combined group A included those with chest RT 15.0 to 34.9 Gy with anthracycline and CED, intermediate-risk combined group B included those with chest RT 15.0 to 34.9 Gy with anthracycline or CED (not both), the low-risk group included those with no RT and both anthracyclines and CED, lastly the other group included those with no chest RT or <15 Gy, and not both CED and anthracycline.
A total of 148 participants missing anthracycline information doxorubicin-equivalent dosing based on Children's Oncology Group Long-Term Follow Up Guidelines 2018.
A total of123 participants missing alkylator information cyclophosphamide-equivalent dose based on Green et al.49
A total of 105 participants missing methotrexate information.
A total of 114 participants missing bleomycin information.
A total of 114 missing corticosteroid information.
A total of 136 missing chest radiation information.
Includes those with no radiation exposure and those with only scatter radiation to the chest/neck.
A total of 135 missing neck radiation information.