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Nephrotoxicity Surveillance for Childhood and Young Adult Survivors of Cancer : Recommendations From the International Late Effects of Childhood Cancer Guideline Harmonization Group

Kooijmans, Esmee C.M. ; Mulder, Renée L. ; Marks, Stephen D. ; Pavasovic, Vesna ; Motwani, Shveta S. ; Walwyn, Thomas ; Larkins, Nicholas G. ; Kruseova, Jarmila ; Constine, Louis S. and Hamish Wallace, W. , et al. (2025) In Journal of Clinical Oncology 43(21). p.2433-2448
Abstract

PURPOSE Childhood, adolescent, and young adult (CAYA) survivors of cancer are at risk of nephrotoxicity. Surveillance guidelines are important for timely diagnosis and treatment of these survivors, which could slow the progression to higher stages of kidney dysfunction. METHODS The International Late Effects of Childhood Cancer Guideline Harmonization Group established a multidisciplinary panel of 34 experts from 11 countries. The panel performed systematic literature reviews for articles published between 1990 and June 2023, graded the evidence using Grading of Recommendations Assessment, Development, and Evaluation methodology, and formulated recommendations based on evidence, clinical judgment, and consideration of benefits and harms... (More)

PURPOSE Childhood, adolescent, and young adult (CAYA) survivors of cancer are at risk of nephrotoxicity. Surveillance guidelines are important for timely diagnosis and treatment of these survivors, which could slow the progression to higher stages of kidney dysfunction. METHODS The International Late Effects of Childhood Cancer Guideline Harmonization Group established a multidisciplinary panel of 34 experts from 11 countries. The panel performed systematic literature reviews for articles published between 1990 and June 2023, graded the evidence using Grading of Recommendations Assessment, Development, and Evaluation methodology, and formulated recommendations based on evidence, clinical judgment, and consideration of benefits and harms of surveillance. Recommendations were critically appraised by two independent external experts and patient representatives. RESULTS Glomerular dysfunction surveillance is recommended every 2-5 years for survivors treated with ifosfamide, cisplatin, abdominal radiotherapy, total body irradiation, or nephrectomy and is reasonable after carboplatin treatment. We recommend screening for glomerular dysfunction using an estimated glomerular filtration rate (eGFR) equation that includes serum creatinine, preferably combined with serum cystatin C if available. Tubular dysfunction surveillance is recommended once at entry into long-term follow-up and with follow-up as clinically indicated for survivors treated with ifosfamide and is reasonable after cisplatin treatment. CONCLUSION These recommendations inform routine, uniform long-term follow-up care for CAYA survivors of cancer at risk of nephrotoxicity.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Oncology
volume
43
issue
21
pages
16 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:105005760016
  • pmid:40393013
ISSN
0732-183X
DOI
10.1200/JCO-24-02534
language
English
LU publication?
yes
id
65b8e39f-58bc-4cd2-a1a4-fcd2933b13ca
date added to LUP
2025-09-29 11:07:48
date last changed
2025-10-02 13:37:48
@article{65b8e39f-58bc-4cd2-a1a4-fcd2933b13ca,
  abstract     = {{<p>PURPOSE Childhood, adolescent, and young adult (CAYA) survivors of cancer are at risk of nephrotoxicity. Surveillance guidelines are important for timely diagnosis and treatment of these survivors, which could slow the progression to higher stages of kidney dysfunction. METHODS The International Late Effects of Childhood Cancer Guideline Harmonization Group established a multidisciplinary panel of 34 experts from 11 countries. The panel performed systematic literature reviews for articles published between 1990 and June 2023, graded the evidence using Grading of Recommendations Assessment, Development, and Evaluation methodology, and formulated recommendations based on evidence, clinical judgment, and consideration of benefits and harms of surveillance. Recommendations were critically appraised by two independent external experts and patient representatives. RESULTS Glomerular dysfunction surveillance is recommended every 2-5 years for survivors treated with ifosfamide, cisplatin, abdominal radiotherapy, total body irradiation, or nephrectomy and is reasonable after carboplatin treatment. We recommend screening for glomerular dysfunction using an estimated glomerular filtration rate (eGFR) equation that includes serum creatinine, preferably combined with serum cystatin C if available. Tubular dysfunction surveillance is recommended once at entry into long-term follow-up and with follow-up as clinically indicated for survivors treated with ifosfamide and is reasonable after cisplatin treatment. CONCLUSION These recommendations inform routine, uniform long-term follow-up care for CAYA survivors of cancer at risk of nephrotoxicity.</p>}},
  author       = {{Kooijmans, Esmee C.M. and Mulder, Renée L. and Marks, Stephen D. and Pavasovic, Vesna and Motwani, Shveta S. and Walwyn, Thomas and Larkins, Nicholas G. and Kruseova, Jarmila and Constine, Louis S. and Hamish Wallace, W. and Green, Daniel M. and Bökenkamp, Arend and van der Pal, Helena J.H. and van den Heuvel-Eibrink, Marry M. and Hjorth, Lars and Andrés-Jensen, Liv and Bardi, Edit and van Dalen, Elvira C. and Demoor-Goldschmidt, Charlotte and Becktell, Kerri and Grönroos, Marika and Kieran, Kathleen and Mironova, Denitza and Terenziani, Monica and Veening, Margreet A. and Zieg, Jakub and Onder, Songul and Onder, Ali Mirza and Routh, Jonathan C. and Thompson, Joel and Hudson, Melissa M. and Kremer, Leontien C.M. and Skinner, Roderick and Ehrhardt, Matthew J.}},
  issn         = {{0732-183X}},
  language     = {{eng}},
  number       = {{21}},
  pages        = {{2433--2448}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Clinical Oncology}},
  title        = {{Nephrotoxicity Surveillance for Childhood and Young Adult Survivors of Cancer : Recommendations From the International Late Effects of Childhood Cancer Guideline Harmonization Group}},
  url          = {{http://dx.doi.org/10.1200/JCO-24-02534}},
  doi          = {{10.1200/JCO-24-02534}},
  volume       = {{43}},
  year         = {{2025}},
}