[Organ dysfunctions caused by cancer therapy in children]

Some of organ dysfunctions due to cancer therapy in children are common to those of adults, but others are specific for children. Even common toxicities may have aspects peculiar to children. For example, cisplatin nephrotoxicity easily causes hypomagnesemic, hypocalcemic tetany in children which is rare in adults. Occurrence of second primary malignancies is serious late effect of cancer therapy. Concerning this problem two factors are important in children. Firstly, children with heritable embryonal cancers are predisposed to develop additional malignancies related and unrelated to therapy. Secondly, proportion of different parts of body of children is different from one of adults and normal tissues distant from the primary radiation field may receive surprisingly large dose of irradiation. For example, a 8-year-old boy received 6 to 9% of dose of prophylactic skull irradiation for acute lymphocytic leukemia to his thyroid. Younger children who have smaller viscerocranium are expected to have larger dose. Children who received antileukemic therapy for 3 to 7 years showed significant delays of linear growth and bone age.