Although more than 80% of children with cancer will survive 5 years after diagnosis, long-term survivors of childhood cancer have an elevated risk of morbidity and early mortality due to late effects of their prior cancer therapy.1 Knowledge of the link between therapeutic exposures and late effects has informed upfront childhood cancer treatment. Contemporary protocols use risk stratification to deintensify therapy for patients at low risk of treatment failure or recurrence, with the goal of limiting radiotherapy dose and fields and reducing cumulative anthracycline and alkylator chemotherapy exposures whenever possible to decrease late effects.