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J Gebauer Department of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck and Institute for Endocrinology and Diabetes, University of Luebeck, Luebeck, Germany

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R Skinner Department of Paediatric and Adolescent Haematology and Oncology and Children’s BMT Unit, Great North Children’s Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, and Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK

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R Haupt DOPO Clinic, Department of Hematology/Oncolgy, IRCCS Istituto Giannina Gaslini, Genova, Italy

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L Kremer Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
Amsterdam UMC, Emma’s Children’s Hospital, Amsterdam, The Netherlands

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H van der Pal Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

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G Michel Department of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland

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G T Armstrong Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA

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M M Hudson Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA

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L Hjorth Department of Clinical Sciences Lund, Paediatrics, Lund University, Skane University Hospital, Lund, Sweden

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H Lehnert Paris Lodron University of Salzburg, Salzburg, Austria

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T Langer Pediatric Hematology and Oncology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany

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-term survivors suffer from treatment-related late effects, which may occur years to decades after the completion of therapy ( 2 ). Increasing knowledge and recognition of these sequelae resulted in, whenever possible, a reduction or even elimination of

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Izabelle Lövgren Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK

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Azadeh Abravan Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, UK

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Abigail Bryce-Atkinson Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK

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Marcel van Herk Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, UK

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efficacy and detrimental side effects, such as secondary neoplasms and endocrine deficiencies, is still needed. As the survival rate has also increased, patients are now living long enough to see these late effects. Common oncological treatments include

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Sidsel Mathiesen Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Kaspar Sørensen Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Marianne Ifversen Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Casper P Hagen Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Jørgen Holm Petersen Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

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Anders Juul Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Klaus Müller Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Introduction Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for children with life-threatening hematological and immunological diseases, including high-risk leukemias, but late effects are becoming prevalent

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Judith Gebauer Department of Internal Medicine I, University Hospital Schleswig-Holstein, Luebeck, Germany

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Claire E Higham Department of Endocrinology, Christie Hospital NHS Foundation Trust, University of Manchester, and Manchester Academic Health Science Centre, Manchester, UK

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represent a comparably small group of patients in this large cohort that have been studied for decades due to their excellent long-term survival rates and the long life span ahead of them after the end of treatment. Much knowledge about late effects is

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David S McLaren Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospital NHS Trust, Leeds, UK

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Aarani Devi Clinical Oncology, Leeds Cancer Centre, Leeds Teaching Hospital NHS Trust, Leeds, UK

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Nikolaos Kyriakakis Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospital NHS Trust, Leeds, UK

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Michelle Kwok-Williams Clinical Oncology, Leeds Cancer Centre, Leeds Teaching Hospital NHS Trust, Leeds, UK

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Robert D Murray Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospital NHS Trust, Leeds, UK
Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK

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). Evolution of conventional XRT The paediatric population, due to their growth and development potential, is particularly sensitive to radiation-induced side effects. Competing objectives to maximise cure and minimise toxicity including late effects are

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Alexander Heinzel RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen, Germany

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Dirk Müller Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany

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Hanneke M van Santen Wilhelmina Children’s Hospital, University Medical Center Utrecht, Department of Pediatric Endocrinology, Utrecht, The Netherlands
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

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Sarah C Clement Wilhelmina Children’s Hospital, University Medical Center Utrecht, Department of Pediatric Endocrinology, Utrecht, The Netherlands
Emma Children’s Hospital, Amsterdam UMC, Department of Pediatrics, Amsterdam, The Netherlands

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Arthur B Schneider University of Illinois at Chicago, Department of Medicine, Chicago, IL, USA

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Frederik A Verburg Erasmus MC Rotterdam, Department of Radiology & Nuclear Medicine, Rotterdam, The Netherlands
University Hospital Würzburg, Department of Nuclear Medicine, Würzburg, Germany

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2018, the International Guideline Harmonization Group (IGHG) on guidelines for late effects of childhood cancer, therefore, released recommendations on surveillance for DTC in at-risk CCS ( 6 ). These guidelines stated that surveillance for DTC may be

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A J Clark Endocrine Connections Editor-in-Chief, Emeritus Professor of Endocrinology, University of London, London, United Kingdom of Great Britain and Northern Ireland

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review articles that relate to paediatric elements of disease and, as an example of this initiative, we are currently publishing an excellent series of articles on the ‘Late effects of cancer therapy in children’ ( https

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Luminita Nicoleta Cima Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

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Anca Colita Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Hematology Department, Fundeni Hospital, Bucharest, Romania

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Simona Fica Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Endocrine Department, Elias Hospital, Bucharest, Romania

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this review. Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. References 1 Brennan BM Shalet SM . Endocrine late effects after bone marrow transplant

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Nikolaos Kyriakakis Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Leeds Institute for Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK

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Marilena Giannoudi Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Satish S Kumar Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Khyatisha Seejore Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Leeds Institute for Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK

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Georgios K Dimitriadis Department of Endocrinology, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Harpal Randeva Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

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Adam Glaser Pediatric Oncology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Leeds Institute of Medical Research, University of Leeds, UK

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Michelle Kwok-Williams Clinical Oncology, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Georgina Gerrard Clinical Oncology, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Carmel Loughrey Clinical Oncology, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Ahmed Al-Qaissi Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Ramzi Ajjan Leeds Institute for Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK

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Julie Lynch Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Robert D Murray Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Leeds Institute for Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK

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primary brain tumours. Individuals with a history of malignant brain tumours of both CO (age ≤ 18 years) and AO (age > 18 years) were invited to participate in the study. Patients were recruited from the adult and childhood late-effects oncology clinics at

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I M A A van Roessel Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands

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J P de Graaf Dutch Pituitary Foundation, Nijkerk, The Netherlands
Department of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
Endo-ERN European Reference Network on Rare endocrine conditions

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N R Biermasz Department of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
Endo-ERN European Reference Network on Rare endocrine conditions

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E Charmandari Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece

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H M van Santen Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands

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of the late effects of their brain tumor treatment until they occurred and therefore did not feel prepared for these late effects. According to the patients, some doctors focus too much on survival rather than on quality of life. Patients

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