Late Effects	Causative Treatment	Signs and Symptoms	Screening and Diagnostic Tests	Management and Intervention
*Adapted from Schwartz et al.[34]
Hepatic fibrosis/cirrhosis	Chemotherapy: methotrexate, actinomycin D, 6-MP, 6-thioguanine (6-TG)	Itching, jaundice, spider nevi, bruising, portal hypertension, esophageal varices, hemorrhoids, hematemesis, encephalopathy	Height and weight each year, CBC, reticulocytes, platelets, each year; liver function studies every 2–5 years (hepatic screen, liver biopsy, endoscopy)	Hepatitis screen (hepatitis A, B, C/ cytomegalovirus [CMV]), diuretics, liver transplant, varices, sclerosis, vascular shunting
	Radiation: >30 Gy
	Surgery: Massive resection

References

34. Schwartz C L, Hobbie WL, Constine LS, et al., eds.: Survivors of Childhood Cancer: Assessment and Management. St. Louis, Mo: Mosby, 1994.