Published research

Articles - what's new?

Neurologic disorders in long-term survivors of neuroblastoma - a population-based cohort study within the Adult Life after Childhood Cancer in Scandinavia (ALiCCS) research program.
Norsker FN, Rechnitzer C, Andersen EW, Linnet KM, Kenborg L, Holmqvist AS, Tryggvadottir L, Madanat-Harjuoja LM, Øra I, Thorarinsdottir HK, Vettenranta K, Bautz A, Schrøder H, Hasle H, Winther JF.
IActa Oncol. 2019 Oct 8:1-7. doi: 10.1080/0284186X.2019.1672892. [Epub ahead of print]PMID: 31591921
Hospital admission for neurologic disorders among 5-year survivors of noncentral nervous system tumors in childhood: A cohort study within the Adult Life after Childhood Cancer in Scandinavia study.
Kenborg L, Linnet KM, de Fine Licht S, Bautz A, Holmqvist AS, Tryggvadottir L, Madanat-Harjuoja LM, Stovall M, Heilmann C, Albieri V, Hasle H, Winther JF; ALiCCS study group.
Int J Cancer. 2019 Apr 13. doi: 10.1002/ijc.32341. [Epub ahead of print]PMID: 30980681
Hyperthyroidism as a late effect in childhood cancer survivors - an Adult Life after Childhood Cancer in Scandinavia (ALiCCS) study.
Clausen CT, Hasle H, Holmqvist AS, Madanat-Harjuoja L, Tryggvadottir L, Wesenberg F, Bautz A, Winther JF, de Fine Licht S.
Acta Oncol. 2019 Feb;58(2):227-231. doi: 10.1080/0284186X.2018.1535187. Epub 2018 Dec 26.PMID: 30585514
Disease-specific Hospitalizations Among 5-Year Survivors of Hepatoblastoma: A Nordic Population-based Cohort Study.
Bonnesen TG, Asdahl PH, de Fine Licht S, Gudmundsdottir T, Holmqvist AS, Madanat-Harjuoja LM, Tryggvadottir L, Winther JF, Hasle AH; ALiCCS Study Group.
J Pediatr Hematol Oncol. 2019 Apr;41(3):181-186. doi: 10.1097/MPH.0000000000001378. PMID: 30557167
Risk of cardiovascular disease among Nordic childhood cancer survivors with diabetes mellitus: A report from adult life after childhood cancer in Scandinavia.
Winther JF, Bhatia S, Cederkvist L, Gudmundsdottir T, Madanat-Harjuoja L, Tryggvadottir L, Wesenberg F, Hasle H, Sällfors Holmqvist A; ALiCCS Study Group.
Cancer. 2018 Nov 15;124(22):4393-4400. doi: 10.1002/cncr.31696. Epub 2018 Oct 11.PMID: 30307617
Neurologic disorders in 4858 survivors of central nervous system tumors in childhood-an Adult Life after Childhood Cancer in Scandinavia (ALiCCS) study.
Kenborg L, Winther JF, Linnet KM, Krøyer A, Albieri V, Holmqvist AS, Tryggvadottir L, Madanat-Harjuoja LM, Stovall M, Hasle H, Olsen JH; ALiCCS study group.
Neuro Oncol. 2019 Jan 1;21(1):125-136. doi: 10.1093/neuonc/noy094.PMID: 29850875
Measuring childhood cancer late effects: evidence of a healthy survivor effect.
Asdahl PH, Ojha RP, Winther JF, Holmqvist AS, de Fine Licht S, Gudmundsdottir T, Madanat-Harjuoja L, Tryggvadottir L, Andersen KK, Hasle H; ALiCCS study group.
IEur J Epidemiol. 2017 Dec;32(12):1089-1096. doi: 10.1007/s10654-017-0305-4. Epub 2017 Nov 28.PMID: 29185125
Liver diseases in Adult Life after Childhood Cancer in Scandinavia (ALiCCS): A population-based cohort study of 32,839 one-year survivors
Bonnesen TG, Winther JF, Andersen KK, Asdahl PH, de Fine Licht S, Gudmundsdottir T, Sällfors Holmqvist A, Madanat-Harjuoja LM, Tryggvadottir L, Wesenberg F, Heilmann C, Olsen JH, Hasle H; ALiCCS study group.
Int J Cancer. 2017 Oct 11. doi: 10.1002/ijc.31093. [Epub ahead of print]
The risk of late effect in the urinary tract for childhood cancer survivors has not been investigated thoroughly. Therefore, we set out to provide an overview of the potential risk of renal and urinary tract diseases survivors may encounter. We used population-based data and included more than 32,000 one-year childhood cancer survivors. We found an overall increased risk of renal and urinary tract diseases. Survivors of leukemia, neuroblastoma, and renal tumors had the highest risk of renal and urinary tract diseases. 
Long-term inpatient disease burden in the Adult Life after Childhood Cancer in Scandinavia (ALiCCS) study: A cohort study of 21,297 childhood cancer survivors
de Fine Licht S, Rugbjerg K, Gudmundsdottir T, Bonnesen TG, Asdahl PH, Holmqvist AS, Madanat-Harjuoja L, Tryggvadottir L, Wesenberg F, Hasle H, Winther JF, Olsen JH; ALiCCS study group.
PLoS Med. 2017 May 9;14(5):e1002296. doi: 10.1371/journal.pmed.1002296. eCollection 2017 May
Survivors of childhood cancer are at increased risk for a wide range of late effects. However, no large population-based studies have included the whole range of somatic diagnoses including subgroup diagnoses and all main types of childhood cancers. Therefore, we aimed to provide the most detailed overview of the long-term risk of hospitalisation in survivors of childhood cancer. We found that childhood cancer survivors have a doubled risk for being admitted to hospital compared with a sample of the general population. Approximately 50% of the excess hospitalisations were for diseases of the nervous system, endocrine system, digestive organs, and respiratory system. Survivors of all types of childhood cancer were at increased, persistent risk for subsequent hospitalisation, the highest risks being those of survivors of neuroblastoma, hepatic tumours, central nervous system tumours, and Hodgkin lymphoma. Survivors spent on average five times as many days in hospital as population comparisons
 
Study protocol

Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia: A population-based cohort study.
Asdahl PH, Winther JF, Bonnesen TG, De Fine Licht S, Gudmundsdottir T, Holmqvist AS, Malila N, Tryggvadottir L, Wesenberg F, Dahlerup JF, Olsen JH, Hasle H; ALiCCS study group.
Int J Cancer. 2016 Oct 1;139(7):1501-11. doi: 10.1002/ijc.30198. Epub 2016 Jun 2.
Childhood cancer late effects of the gastroenterological tract has been sparsely investigated. In the current study, we aimed to give a comprehensive overview of all these diseases. We used the unique population-based ALiCCS setup and included more than 33,000 childhood cancer survivors. We found an overall increased rate of gastrointestinal diseases. This result covered over a number of specific gastrointestinal diseases with increased risk including ileus, esophageal stricture, liver cirrhosis, and pancreatitis. Survivors of leukemia, neuroblastoma, renal tumors, and hepatoblastoma had the highest risk of gastrointestinal
disease.

Long-term risk of renal and urinary tract diseases in childhood cancer survivors: A population-based cohort study.
Bonnesen TG, Winther JF, Asdahl PH, de Fine Licht S, Gudmundsdottir T, Sällfors Holmqvist A, Madanat-Harjuoja LM, Tryggvadottir L, Wesenberg F, Birn H, Olsen JH, Hasle H; ALiCCS study group.
Eur J Cancer. 2016 Sep;64:52-61. doi: 10.1016/j.ejca.2016.05.006.
The risk of late effect in the urinary tract for childhood cancer survivors has not been investigated thoroughly. Therefore, we set out to provide an overview of the potential risk of renal and urinary tract diseases survivors may encounter. We used population-based data and included more than 32,000 one-year childhood cancer survivors. We found an overall increased risk of renal and urinary tract diseases. Survivors of leukemia, neuroblastoma, and renal tumors had the highest risk of renal and urinary tract diseases.

Autoimmune diseases in Adult Life after Childhood Cancer in Scandinavia (ALiCCS)
Anna Sällfors Holmqvist, Jørgen H Olsen, Lene Mellemkjaer, Stanislaw Garwicz, Lars Hjorth, Christian Moëll, Bengt Månsson, Laufey Tryggvadottir, Henrik Hasle, Jeanette Falck Winther; on behalf of the ALiCCS study group
Ann Rheum Dis. 2015 Nov 10. pii: annrheumdis-2015-207659. doi: 10.1136/annrheumdis-2015-207659. [Epub ahead of print]
The pattern of autoimmune diseases in childhood cancer survivors has not been investigated previously. We estimated the risk for autoimmune disease after childhood cancer in a large, population-based setting with outcome measures from comprehensive, nationwide health registries. We found that childhood cancer survivors had a significantly increased relative risk of all autoimmune diseases combined, and for several specific autoimmune diseases, such as autoimmune hemolytic anemia, Addison disease, polyarteritis nodosa, chronic rheumatic heart disease, localized scleroderma, idiopathic thrombocytopenic purpura, and Hashimoto thyroiditis. The relative risk for any autoimmune disease were significantly increased after treatment for leukemia, Hodgkin lymphoma, renal tumors, and central nervous system neoplasms. These findings underscore the need for prolonged follow-up of survivors of childhood cancer.

Hospital contacts for endocrine disorders in Adult Life after Childhood Cancer in Scandinavia (ALiCCS): a population-based cohort study.
de Fine Licht S, Winther JF, Gudmundsdottir T, Holmqvist AS, Bonnesen TG, Asdahl PH, Tryggvadottir L, Anderson H, Wesenberg F, Malila N, Holm K, Hasle H, Olsen JH; ALiCCS study group.
Lancet. 2014 Jun 7;383(9933):1981-9. doi: 10.1016/S0140-6736(13)62564-7. Epub 2014 Feb 18.
Long-term follow-up of 1-year childhood cancer survivors exposed to Nordic treatment regimens since the 1940s and 1950s showed a notably increased risk for hospital contacts for a wide range of endocrine disorders. The risk estimates for outcomes associated with specific childhood cancers were largely comparable to those reported from the USA. In our study, pituitary hypofunction, hypothyroidism, and gonadal dysfunction were the most prevalent disease-induced and treatment-induced late effects. The risk was especially high for survivors of leukaemia and CNS tumours and for those whose cancer was diagnosed when they were 5–9 years of age. Our study was based on medically verified diagnoses and survivors were followed up well beyond 40 years of age. Our findings add to the growing body of evidence that endocrine late effects remain a main health concern of survivors of childhood cancer throughout life. With the progressively increasing survival rates of childhood cancer, this fact emphasises the importance of minimisation of damaging treatment, intensification of secondary prevention, and following of survivors for life.

 

Adult life after childhood cancer in Scandinavia: diabetes mellitus following treatment for cancer in childhood.
Holmqvist AS, Olsen JH, Andersen KK, Licht Sde F, Hjorth L, Garwicz S, Moëll C, Anderson H, Wesenberg F, Tryggvadottir L, Malila N, Boice JD Jr, Hasle H, Winther JF; ALiCCS study group.
Eur J Cancer. 2014 Apr;50(6):1169-75. doi: 10.1016/j.ejca.2014.01.014. Epub 2014 Feb 4.
The remarkably increased survival after childhood cancer has come at the prize of late complications. This population-based retrospective cohort study of 33,000 childhood cancer survivors in the five Nordic countries was conducted to characterize the risk of diabetes mellitus among long-term survivors. This ALiCCS study showed that childhood cancer survivors had an overall 1.6-fold increased risk of diabetes mellitus compared to a comparison cohort from the general population. This increased risk persisted throughout life. The survivors were found to have an increased risk for both type 1 and type 2 diabetes mellitus.

Cardiovascular disease in Adult Life after Childhood Cancer in Scandinavia: A population-based cohort study of 32,308 one-year survivors.

Gudmundsdottir T, F Winther J, de Fine Licht S, G Bonnesen T, H Asdahl P, Tryggvadottir L, Anderson H, Wesenberg F, Malila N, Hasle H, H Olsen J; ALiCCS study group.
Int J Cancer. 2015 Feb 3. doi: 10.1002/ijc.29468. [Epub ahead of print] PMID: 25648592
The long-term effects of cancer treatment in childhood cancer survivors can be serious, and more research is needed to fully investigate the relationship between treatment and chronic disease in aging survivors. This retrospective population-based cohort study focused on cardiovascular late effects among childhood cancer survivors in the five Nordic countries. Survivors were found to be at significantly increased risk for cardiovascular disease throughout their lives. Relative risk was highest for heart failure, valvular dysfunction, and cerebrovascular diseases. Overall, survivors had a twofold increased lifetime risk for hospitalization for cardiovascular disease.

Childhood Cancer survivor cohorts in Europe.

Winther JF, Kenborg L, Byrne J, Hjorth L, Kaatsch P, Kremer LC, Kuehni CE, Auquier P, Michel G, de Vathaire F, Haupt R, Skinner R, Madanat-Harjuoja LM, Tryggvadottir L, Wesenberg F, Reulen RC, Grabow D, Ronckers CM, van Dulmen-den Broeder E, van den Heuvel-Eibrink MM, Schindler M, Berbis J, Holmqvist AS, Gudmundsdottir T, de Fine Licht S, Bonnesen TG, Asdahl PH, Bautz A, Kristoffersen AK, Himmerslev L, Hasle H, Olsen JH, Hawkins MM.
Acta Oncol. 2015 May;54(5):655-68. doi: 10.3109/0284186X.2015.1008648. Epub 2015 Mar 27. PMID:  25813473

The Adult Life after Childhood Cancer in Scandinavia (ALiCCS) study: Design and characteristics.

Asdahl PH, Winther JF, Bonnesen TG, De Fine Licht S, Gudmundsdottir T, Anderson H, Madanat-Harjuoja L, Tryggvadottir L, Småstuen MC, Holmqvist AS, Hasle H, Olsen JH; ALiCCS Study Group.
Pediatr Blood Cancer. 2015 Jul 20. doi: 10.1002/pbc.25661. [Epub ahead of print] PMID: 26193842
Long-term follow-up of childhood cancer survivors have shown a number of health related problems associated to cancer treatment. However, lifelong follow-up without selective loss to follow-up is impossible in most setting. Yet, the Nordic countries are different because the unique personal identification number makes it possible to follow subjects lifelong, link information from different registries, and find a suitable comparison population. In this manuscript, we give a detailed description of the information from various registries that have been collected for the ALiCCS study. Also, we present characteristics of the study cohort including basic survival data.

Posters

Conference

15th International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer,
15-17 June 2017, Atlanta, Georgia, USA

Poster Risk of Cardiovascular Disease among Nordic Childhood Cancer Survivors with Diabetes Mellitus - an "Adult Life after Childhood Cancer in Scandinavia" (ALiCCS) Study (Anna Sällfors Holmqvist)
Poster Socioeconomic Consequences in Adult Life after Childhood Cancer in Scandinavia: Rational and Design of a three Nordic Country-Wide Poupulation-Based study (Friederike Erdmann)

Conference

Nordic Society of Pediatric Hematology and Oncology (NOPHO) 35th Annual Meeting
19-23 May 2017, Stockholm, Sweden

Poster Late effects in survivors of childhood leukemia - A Nordic population-based cohort study (Gitte Vrelits Sørensen)

Conference

The Fifth European Symposium on Late Complications after Childhood Cancer (ESLCCC 16)
22-23. September 2016, Copenhagen, Denmark

Poster

Measuring childhood cancer late effects - evidence of a healthy survivor effect
(Peter Haubjerg Asdahl)

Poster

Disease specific hospitalizations among survivors of Wilms tumor: A Nordic population-based cohort study (Stine Høgsholt) 

Conference 14th International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer
11-13 June 2015, Arlington, VA, USA
Poster Liver Diseases in Long-term Childhood Cancer Survivors: a population-based cohort study
Poster Hospitalizations among survivors of Wilms tumor: A Nordic population-based cohort study
Poster Malignant bone tumors in Nordic children and risk of late effects
Poster Hospitalization for somatic disease in survivors Of Neuroblastoma in Scandinavia
Poster Hospitalizations among survivors of Wilms tumor: A Nordic population-based cohort study (Peter H. Asdahl)

Conference NOPHO 33rd Annual Meeting
22-26 May 2015, Oulu, Finland
Poster Liver Diseases in Long-term Childhood Cancer Survivors: a population-based cohort study
Conference The Fourth European Symposium on Late Complications after Childhood Cancer (ESLCCC14)
15-16 September 2014, Edinburgh, Scotland
Poster Renal and Urinary Tract Diseases in Adult Life after Childhood Cancer in Scandinavia - a population-based cohort study of 32 519 one-year survivors (Trine Gade Bonnesen)
Poster Neurologic disease in survivors of childhood cancer located outside CNS: an ALiCCS study (Adult Life after Childhood Cancer in Scandinavia)
Poster Gastrointestinal and liver diseases in adult life after childhood cancer in Scandinavia (ALiCCS): A population-based cohort study of 31,132 one-year survivors. (Peter Haubjerg Asdahl)
Conference

Danish Cancer Society Symposium, Denmark Cardiotoxicity in Cancer Survivors – Achieving cure without a broken heart
16-18 June 2014, Copenhagen

Poster

Poster prize: Cardiovascular Disease in Adult Life after Childhood Cancer in Scandinavia (ALiCCS)
(Thorgerdur Gudmundsdottir)

Conference Annual meeting 2014 for Nordic Society of Pediatric Hematology and Oncology.
Poster Gastrointestinal disease in Adult Life After Childhood Cancer in Scandinavia (ALiCCS): A population-based cohort study of 31,132 one-year survivors

Conference The Third European Symposium on Late Complications after Childhood Cancer (ESLCCC11)
29-30 Sept 2011, Amsterdam, Netherlands
Poster An introduction to the ALiCCS study

Adult Life after Childhood Cancer in Scandinavia
Sofie de Fine Licht, Thorgerdur Gudmundsdottir,
Lars M Stensman, 2012

 

Oral Presentations

Conference Childhood Leukemia Early Adverse Reaction (Clear) conference, 1-3 July 2017, Elsenor, Denmark
Presentation Disease-specific hospitalization in survivors of childhood leukemia in the "Adult Life after Childhood Cancer in Scandinavia (ALiCCS) cohort (Gitte Vrelits Sørensen)
Conference 15th International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer,
15-17 June 2017, Atlanta, Georgia, USA
Presentation Long-term Inpatient Disease Burden in Childhood Cancer Survivors (Sofie de Fine Licht)
Presentation Neurologic Disorders in Survivors of Non-CNS Childhood Cancer: An "Adult Life after Childhood Cancer in Scandinavia" (ALiCCS) study (Line Kenborg)
Conference The Fifth European Symposium on Late Complications after Childhood Cancer (ESLCCC16), 22-23 September 2016, Copenhagen, Denmark
Presentation Long-term disease-specific hospitalization in survivors of childhood leukemia in the "Adult Life after TChildhood Cancer in Scandinavia (ALiCCS) cohort (Gitte Vrelits Sørensen)
Conference 33rd Nordic Society of Pediatric Hematology and Oncology (NOPHO) Annual meeting, 
22 - 26 May, 2015, Oulu, Finland
Presentation Disease specific hospitalizations among survivors of Wilms tumor: A Nordic population-based cohort study (Stine Høgsholt).
Presentation Health-condition in survivors of Wilms tumor: A Nordic population-based cohort study (Stine Høgsholt)
Conference 14th International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer,
11-13. June, 2015, Arlington, VA, USA
Presentation Neurological Disorders in Survivors of Childhood CNS Tumor: An "Adult Life after Childhood Cancer in Scandinavia" (ALiCCS) Study (Line Kenborg).

Conference The Fourth European Symposium on Late Complications after Childhood Cancer (ESLCCC14)
15-16 September 2014, Edinburgh, Scotland  
Presentation Autoimmune diseases following treatment for cancer in childhood – an ALiCCS study (Adult Life after Childhood Cancer in Scandinavia) (Anna Sällfors Holmqvist)

Conference Danish Cancer Society Symposium
16-18 June 2014, Copenhagen, Denmark  
Presentation Poster Prize: Cardiovascular Disease in Adult Life after Childhood Cancer in Scandinavia (ALiCCS) (Thorgerdur Gudmundsdottir)

Conference

32nd Annual NOPHO meeting (Nordic Society of Pediatric Hematology and Oncology) 9-13 May 2014, Bergen, Norway.

Presentation

Hospitalizations for Respiratory Disorders in Adult Life after Childhood Cancer in Scandinavia (Thorgerdur Gudmundsdottir)

Conference 31th Annual NOPHO meeting (Nordic Society of Paediatric Haematology and Oncology)
31 May - 4 June 4 2013, Copenhagen, Denmark
Presentation Adult Life after Childhood Cancer in Scandinavia - Renal Late effects in Childhood Cancer Survivors (Trine Gade Bonnesen)

Conference PhD Course and Symposium, Pediatric Oncology Research
9 Nov 2012, Stockholm, Sweden
Presentation An introduction to ALiCCS

Conference 12th International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer
8-9 june 2012, Williamsburg VA, USA
Presentation Cardiovascular late effects in childhood cancer survivors

Conference CCSS Annual Investigators' Meeting
(Childhood Cancer Survivor Study)
6-7 June 2012, Williamsburg VA, USA
Presentation An introduction to ALiCCS

Conference 30th Annual NOPHO meeting (Nordic Society of Paediatric Haematology and Oncology
19-22 May 2012, Uppsala, Sweden
Presentation Endocrine late effects in childhood cancer survivors
Presentation Cardiovascular late effects in childhood cancer survivors (Thorgerdur Gudmundsdottir)

PhD dissertations

Seroius Late Effects of Childhood Cancer

 
Thorgerdur Gudmundsdottir

University of Copenhagen, Denmark 2017

Late Effects in Childhood Cancer Survivors

 
Sofie de Fine Licht

University of Copenhagen, Denmark 2017

Long-term hepatic and renal complications in Nordic childhood cancer survivors

 
Trine Gade Bonnesen

Aarhus University, Denmark 2016

Late Gastrointestinal disease among survivors of Childhood Cancer

 
Peter Haubjerg Asdahl

Aarhus University, Denmark 2016

Long-term Morbidity and Socioeconomic Outcome among Nordic Childhood Cancer Survivors

 
Anna Sällfors Holmqvist

Lund University, Sweden 2015