Absence of birth defects in offspring of women treated with dactinomycin

To the Editor: In a study of birth defects among the offspring of survivors of cancer in childhood and adolescence, Green et al. (July 18 issue) found congenital heart disease in 2 of 20 children born to eight women who received dactinomycin as part of their anticancer therapy.¹ To see whether we could replicate this unexpected finding, we determined the occurrence of birth defects among the offspring of similar survivors studied at five centers by the National Cancer Institute.^{2 , 3} None of the 52 offspring born to 36 survivors ( 11 men and 25 women) who had been treated with dactinomycin. . .