Psychosocial outcomes in long term survivors of childhood cancer in Hong Kong

This journal suppl. entitled: Supplement: SIOP Abstratcs: 45th Congress of the International Society of Paediatric Oncology (SIOP) ... 2013Poster Session - Late Effects: abstract no. P-0473PURPOSE/OBJECTIVE: To evaluate the psychosocial outcomes in long-term survivors of childhood cancer in Hong Kong. MATERIALS AND METHODS: Childhood cancer survivors who had completed anti-cancer treatment in five paediatric oncology centers in Hong Kong for at least 5 years were recruited. They were individually interviewed by social worker from Hong Kong Children’s Cancer Foundation (CCF). RESULTS: Total of 733 childhood cancer survivors were recruited from 2007 to 2012 (male = 441; female = 292; age range: 5-39). There were 107 (14.6%) survivors identified of psychosocial problems. They were survivors of leukaemia = 45, lymphoma = 9, solid tumour = 30, brain tumour: 21, born tumour = 2. The psychosocial problems included study failure ? 35(5%); employment difficulty = 20(3%); emotional problem = 12(1.6%); interpersonal social skill problem = 9(1.2%); family relation problem = 4(0.5%); others = 27(3.6%). Specific services were further provided to these survivors by the CCF family service centre. Survivors were referred to study tuition class = 43(5.9%); vocation training or employment assisting program = 77(10.5%) and clinical psychologist counseling = 7(1%). CONCLUSIONS: This study showed a significant percentage of childhood cancer survivors in Hong Kong suffered from psychosocial problems. Study and employment failure were the most common problems. Specific supportive service should be provided to the long term survivors

Clinical Presentations and Outcome of Hospitalised Paediatric Oncology Patients with Laboratory-confirmed Pandemic H1N1 Influenza Infection in Hong Kong MMK SHING Pandemic H1N1 Infection in Paediatric oncology Patients 199

Abstract Objective: The clinical course of hospitalised paediatric oncology patients and haematopoietic stem cell transplant (HSCT) recipients with laboratory-confirmed pandemic H1N1 influenza infection were studied. Methods: Data from oncology patients and HSCT recipients with hospitalised laboratory-confirmed pandemic H1N1 influenza infection in Hong Kong were collected. Parameters on initial presentations, clinical course, treatment regimens and outcome were studied. Results: Sixteen patients were studied, the median age was 12.4 years. Fever (100%), cough (75.0%), runny nose (56.3%) and sore throat (50.0%) were the most common presenting symptoms. Antiviral therapy was started at median 1 day after onset of fever. HSCT recipients were more common to require a repeated or prolonged course of antiviral therapy due to persistent respiratory symptoms. Our cohort recovered without severe complications. Conclusion: Fever, cough, runny nose and sore throat were the most common presenting symptoms. HSCT recipients were more likely to develop persistent or recurrent respiratory symptoms and required repeated course of antiviral therapy. The uncomplicated course of pandemic H1N1 infection of paediatric oncology and HSCT recipients might be related to the early initiation of antiviral therapy

Reduced cardiopulmonary fitness in childhood acute lymphoblastic leukemia survivors

This journal suppl. entitled: Supplement: SIOP Abstratcs: 45th Congress of the International Society of Paediatric Oncology (SIOP) ... 2013Poster Session - Late Effects: abstract no. P-0478PURPOSE/OBJECTIVE: One in 600 adult individuals in USA is a survivor of childhood cancers. A number of chemotherapeutic agents are associated with long-term cardiopulmonary toxicities. Low cardiopulmonary fitness is a strong predictor of all-cause mortality, cardiovascular disease and functional limitations. The purpose of this study was to evaluate cardiopulmonary fitness in Chinese paediatric acute lymphoblastic leukemia (ALL) survivors and to identify high risk group for early behavioral modification. MATERIALS AND METHODS: Childhood ALL survivors were recruited. Cardiopulmonary fitness expressed as peak oxygen consumption (peak VO2) was measured. Exercise response of ALL survivors was compared to a group of age, gender and BMI matched healthy controls. Maximal effort was defined as a respiratory exchange ratio (RER) > 1.10 with clear signs of exhaustion RESULTS: Fifty-one survivors (27 males, 24 females) with a mean age of 18.3 +/- 4.5 years were included in the analysis. Peak VO2 was significantly reduced in survivors compared with controls (35.2 +/- 9.8 vs 39.9 +/- 11.9 mL x Kg -1 x min -1 respectively, p < 0.05). Survivors also had significantly lower peak heart rate (HR) (186 +/- 9 vs 192 +/- 11 bpm, p < 0.05) and greater heart rate reserve (HRR) (5.3 +/- 9.8 vs -0.9 +/- 11.5 bpm, p < 0.05) than controls. Sixty-seven percent of survivors (15 males, 19 females) failed to achieve a peak HR greater than 95% of predicted maximal HR, compared to 41% in the control group (p < 0.05). The mean duration from assessment and termination of treatment for survivors with suboptimal peak HR (n = 34) vs those who could achieved optimal peak HR (n = 17) was 8.9 +/- 3.5 and 12.2 +/- 4.7 years respectively (p < 0.05). ALL risk stratifications in these 2 groups were similar. CONCLUSIONS: Significant proportion of ALL long-term survivors had reduced cardiopulmonary fitness which was a negative risk factor or subsequent cardiovascular risk. Early behavioral modifications are probably justified in this group of patients

Cardiac Magnetic Resonance Assessment of myocardial iron load and fibrosis in adult survivors of childhood leukaemias

Poster Presentatio