CPHON Late Effects of Childhood Cancer Treatment

Question 1

A childhood cancer survivor who received anthracycline chemotherapy is at greatest risk for which late effect?

Accepted Answer

Cardiotoxicity and cardiomyopathy

Answer

Anthracyclines (doxorubicin, daunorubicin) cause cumulative dose-dependent cardiotoxicity, leading to cardiomyopathy and congestive heart failure as a significant late effect in childhood cancer survivors.

Question 2

Which childhood cancer treatment is most closely associated with the late effect of secondary leukemia?

Accepted Answer

Alkylating agents such as cyclophosphamide

Answer

Alkylating agents are associated with therapy-related myelodysplastic syndrome (t-MDS) and secondary acute myeloid leukemia (t-AML), typically occurring 5–10 years after initial treatment.

Question 3

A 16-year-old survivor of childhood ALL who received cranial radiation reports difficulty concentrating and declining academic performance. This is most consistent with which late effect?

Accepted Answer

Neurocognitive impairment

Answer

Cranial radiation disrupts developing white matter and neural circuitry, leading to neurocognitive late effects including attention difficulties, processing speed deficits, and academic challenges—particularly in children treated at younger ages.

Question 4

Which endocrine late effect is most commonly seen in children who received total body irradiation (TBI) as part of a stem cell transplant conditioning regimen?

Accepted Answer

Growth hormone deficiency

Answer

TBI damages the hypothalamic-pituitary axis, most commonly affecting growth hormone secretion. Growth hormone deficiency is the most frequent endocrine late effect, leading to short stature if untreated.

Question 5

A survivor of Wilms tumor who received flank radiation is at risk for which musculoskeletal late effect on the irradiated side?

Accepted Answer

Scoliosis and spinal asymmetry

Answer

Radiation to the flank in young children damages vertebral growth plates asymmetrically, leading to scoliosis and spinal curvature as bone on the irradiated side grows less than the contralateral side.

CPHON Exam Practice Test

CPHON Exam Practice Test

CPHON Late Effects of Childhood Cancer Treatment