Solid organ transplant after treatment for childhood cancer: A report from the Childhood Cancer Survivor Study.

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Your abstract submission has been received You have submitted the following abstract to the 2017 ASCO Annual Meeting (June 2-6, 2017). Receipt of this notice does not guarantee that your submission was complete, free of errors, or accepted for presentation. Abstract notifications will be sent to the First Author by April 3, 2017. Solid organ transplant after treatment for childhood cancer: A report from the Childhood Cancer Survivor Study. Andrew Charles Dietz, Kristy Seidel, Wendy M. Leisenring, Daniel A. Mulrooney, Jean M. Tersak, Richard D. Glick, Cathy A Burnweit, Daniel M. Green, Lisa Diller, Kevin C. Oeffinger, Susan A Smith, Rebecca M Howell, Marilyn Stovall, Leslie L. Robison, Gregory T. Armstrong, Amanda M. Termuhlen; Children's Hospital Los Angeles, Los Angeles, CA; Fred Hutchinson Cancer Research Center, Seattle, WA;, Memphis, TN; Children's Hosp of Pittsburgh, Pittsburgh, PA; Steven & Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY; Nicklaus Children s Hospital, Miami, FL; Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX Abstract Text: Background: Childhood cancer therapy is associated with late onset, organ-specific impairment. However, the prevalence of and outcomes after solid organ transplant (SOT) in childhood cancer survivors (CCS) are unknown. Methods: Data on U.S-based participants in the Childhood Cancer Survivor Study were linked with the Organ Procurement and Transplantation Network. Cumulative incidence of transplant (CIT) 35 years after cancer diagnosis, multivariable Cox regression models for hazard ratios (HR), Kaplan-Meier (KM) survival and corresponding 95% confidence intervals (CI) were estimated. Results: Among 13,318 survivors, median followup age 39 years (interquartile range, IQR 33-46), and median time since cancer diagnosis 31 years (IQR 28-36 years), 100 CCS had SOT after study entry with characteristics and outcomes provided (table). Kidney Heart Liver Lung Number of SOT 50 37 9 7 Wait List Only 25 15 6 21 CIT (95% CI) 0.39% (0.27-0.51) 0.30% (0.20-0.40) 0.07% (0.02-0.12) 0.05% (0.01-0.08) Wait List or SOT 0.54% (0.40-0.67) 0.49% (0.36-0.62) 0.19% (0.10-0.27) 0.10% (0.04-0.16) Median (IQR) Age in 2 ( < 1-9) 6 (3-11) 6 (4-9) 12 ( < 1-16) years at Cancer Diagnosis Median (IQR) Age in 25 (20-35) 28 (21-32) 37 (25-38) 30 (27-37) years at SOT https://asco.confex.com/asco/2017/sci/papers/confirmation.cgi?user EntryTable=Paper&step=9&StepEntry=535-Paper187290&password=172001 Page 1 of 7

Risk Factors for Nephrectomy Anthracylines Actinomycin Carmustine SOT or Wait List (4.1, 2.2-7.6) > 0-150 mg/m 2 (HR, 95% CI)* Ifosfamide (8.4, 2.2-32.6) (3.8, 1.3-11.3) (12.3, 3.1-48.9) Methotrexate (IV/IM) Lung Radiation (22.7, 6.8-75.5) Total Body Irradiation (7.0, 2.3-21.3) Kidney Radiation > 10-20 Gy (2.3, 1.1-4.7) > 20 Gy (4.6, 1.1-19.5) 151-300 mg/m 2 (5.0, 1.3-19.5), 301-450 mg/m 2 (26.5, 9.9-71.0) > 450 mg/m 2 (94.2, 35.3-251.2) Heart Radiation > 20-30 Gy (6.1, 1.8-20.6) > 30 Gy (19.7, 7.1-54.2) (3.3, 1.0-10.2) > 10 Gy (15.6, 2.6-92.7) Five-Year Survival 93.5% 80.6% 27.8% 34.3% after SOT (95% CI) (81.0-97.9) (63.6-90.3) (4.4-59.1) (4.8-68.6) 3 patients had different prior SOT, *only HR with p < 0.05 shown. Conclusions: Organ-specific radiation and chemotherapy exposure increase the risk for SOT after childhood cancer. Five-year survival rates after renal and cardiac SOT are favorable. https://asco.confex.com/asco/2017/sci/papers/confirmation.cgi?user EntryTable=Paper&step=9&StepEntry=535-Paper187290&password=172001 Page 2 of 7

Title: Solid organ transplant after treatment for childhood cancer: A report from the Childhood Cancer Survivor Study. Submitter's E-mail Address: adietz@chla.usc.edu Is this a late-breaking data submission? Is this abstract a clinical trial? Would like to be considered for a Merit Award: Have the data in this abstract been presented at another major medical meeting? Has this research been submitted for publication in a medical journal? Type of Research: Cohort Study Research Category: Clinical Continued Trial Accrual: Received Grant funding: Relevant to geriatric oncology: Sponsor: Andrew Charles Dietz, MD, MS First Author Presenting Author Corresponding Author Andrew Charles Dietz, MD, MS Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, CA 90027 Phone Number: 858-966-5811 Email: adietz@chla.usc.edu Second Author Kristy Seidel Fred Hutchinson Cancer Research Center Seattle, WA 98109 https://asco.confex.com/asco/2017/sci/papers/confirmation.cgi?user EntryTable=Paper&step=9&StepEntry=535-Paper187290&password=172001 Page 3 of 7

Phone Number: 206-667-4374 Email: kseidel@rhcrc.org Third Author Wendy M. Leisenring, ScD Fred Hutchinson Cancer Research Center Seattle, WA 98109 Phone Number: 206-667-4374 Email: wleisenr@fhcrc.org Fourth Author Daniel A. Mulrooney, MD, MS MS735 262 Danny Thomas Pl Memphis, TN 38105 Phone Number: 901-595-5847 Email: daniel.mulrooney@stjude.org Fifth Author Jean M. Tersak, MD Children's Hosp of Pittsburgh 4401 Penn Ave Pittsburgh, PA 15224 Phone Number: 412-692-5055 Email: jean.tersak@chp.edu Sixth Author Richard D. Glick, MD Steven & Alexandra Cohen Children's Medical Center of New York 269-01 76th Avenue Suite CH158, Pediatric Surgery New Hyde Park, NY 11040 Phone Number: 718-470-3636 Email: rglick@nshs.edu Seventh Author Cathy A Burnweit, MD Nicklaus Children s Hospital Miami, FL Email: cathy.burnweit@mch.com https://asco.confex.com/asco/2017/sci/papers/confirmation.cgi?user EntryTable=Paper&step=9&StepEntry=535-Paper187290&password=172001 Page 4 of 7

Eighth Author Daniel M. Green, MD 262 Danny Thomas Place Mail Stop 735 Memphis, TN 38105-2794 Phone Number: 901-595-5915 Fax Number: 901-595-5845 Email: daniel.green@stjude.org Ninth Author Lisa Diller, MD Dana-Farber Cancer Institute and Harvard Medical School 450 Brookline Avenue Boston, MA 02215 Phone Number: 617-632-5642 Email: lisa_diller@dfci.harvard.edu Tenth Author Kevin C. Oeffinger, MD Memorial Sloan Kettering Cancer Center New York, NY 10065 Phone Number: 646-888-4731 Email: oeffingk@mskcc.org Eleventh Author Susan A Smith, MPH Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center Houston, TX Email: sasmith@mdanderson.org Twelfth Author Rebecca M Howell, PhD The University of Texas MD Anderson Cancer Center Houston, TX Email: rhowell@mdanderson.org Thirteenth Author Marilyn Stovall, PhD Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center 1515 Holcombe Blvd Unit 605 Houston, TX 77030 https://asco.confex.com/asco/2017/sci/papers/confirmation.cgi?user EntryTable=Paper&step=9&StepEntry=535-Paper187290&password=172001 Page 5 of 7

Phone Number: 713-745-8999 Email: mstovall@mdanderson.org Fourteenth Author Leslie L. Robison, PhD 262 Danny Thomas Place Mail Stop 735 Memphis, TN 38105 Phone Number: 901-595-3384 Email: les.robison@stjude.org Fifteenth Author Gregory T. Armstrong, MD, MSCE 262 Danny Thomas Place Mailstop 735 Memphis, TN 38105 Phone Number: 901-595-5892 Email: greg.armstrong@stjude.org Sixteenth Author Amanda M. Termuhlen, MD Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, CA 90027 Phone Number: 614-722-3552 Fax Number: 614-722-3699 Email: atermuhlen@chla.usc.edu If necessary, you can make changes to your abstract between now and the deadline of Tuesday, February 7, 2017 To access your submission in the future, use the direct link to your abstract submission from one of the automatic confirmation emails that were sent to you during the submission. Or point your browser to /asco/reminder.cgi to have that URL mailed to you again. Your username/password are 187290/172001. Any changes that you make will be reflected instantly in what is seen by the reviewers. You DO NOT need to go through all of the submission steps in order to change one thing. If you want to change the title, for example, just click "Title" in the abstract control panel and submit the new title. When you have completed your submission, you may close this browser window. https://asco.confex.com/asco/2017/sci/papers/confirmation.cgi?user EntryTable=Paper&step=9&StepEntry=535-Paper187290&password=172001 Page 6 of 7

Tell us what you think of the abstract submission process Home Page https://asco.confex.com/asco/2017/sci/papers/confirmation.cgi?user EntryTable=Paper&step=9&StepEntry=535-Paper187290&password=172001 Page 7 of 7