Twenty-five-year follow-up among survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study Journal Article
| Authors: | Mody, R.; Li, S.; Dover, D. C.; Sallan, S.; Leisenring, W.; Oeffinger, K. C.; Yasui, Y.; Robison, L. L.; Neglia, J. P. |
| Article Title: | Twenty-five-year follow-up among survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study |
| Abstract: | Survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for late effects of cancer therapy. Five-year ALL survivors (< 21 years at diagnosis; n = 5760 eligible, 4151 participants), diagnosed from 1970 to 1986 were compared with the general population and a sibling cohort (n = 3899). Cumulative mortality of 5760 5-year survivors was 13% at 25 years from diagnosis. Recurrent ALL (n = 483) and second neoplasms (SNs; n = 89) were the major causes of death. Among 185 survivors, 199 SNs occurred, 53% in the CNS. Survivors reported more multiple chronic medical conditions (CMCs; odds ratio [OR], 2.8; 95% CI, 2.4-3.2) and severe or life-threatening CMCs (OR, 3.6; 95% CI, 3.0-4.5) than siblings. Cumulative incidence of severe CMCs, including death, 25 years from diagnosis was 21.3% (95% CI, 18.2-24.4; 23.3% [95% CI, 19.4-27.2] and 13.4% [95% CI, 8.4-18.4] for irradiated and nonirradiated survivors, respectively). Survivors reported more adverse general and mental health, functional impairment, and activity limita tions compared with siblings (P< .001). Rates of marriage, college graduation, employment, and health insurance were all lower compared with sibling controls (P < .001). Long-term survivors of childhood ALL exhibit excess mortality and morbidity. Survivors who received radiation therapy as part of their treatment or had a leukemia relapse are at greatest risk for adverse outcomes. © 2008 by The American Society of Hematology. |
| Keywords: | survival; adolescent; adult; cancer survival; child; controlled study; preschool child; aged; child, preschool; middle aged; survival analysis; survival rate; major clinical study; clinical trial; mortality; outcome assessment; recurrent cancer; follow up; follow-up studies; cohort studies; incidence; morbidity; cohort analysis; risk factors; recurrence; risk factor; acute lymphoblastic leukemia; cancer survivor; chronic disease; health insurance; cause of death; survival time; disease severity; health status; infant; infant, newborn; multicenter study; newborn; mental disease; recurrent disease; precursor cell lymphoblastic leukemia-lymphoma; neoplasms, second primary; lymphatic leukemia; second cancer; educational status; marriage; academic achievement; insurance, health; functional disease; employment |
| Journal Title: | Blood |
| Volume: | 111 |
| Issue: | 12 |
| ISSN: | 0006-4971 |
| Publisher: | American Society of Hematology |
| Date Published: | 2008-06-15 |
| Start Page: | 5515 |
| End Page: | 5523 |
| Language: | English |
| DOI: | 10.1182/blood-2007-10-117150 |
| PUBMED: | 18334672 |
| PROVIDER: | scopus |
| PMCID: | PMC2424150 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 51" - "Export Date: 17 November 2011" - "CODEN: BLOOA" - "Source: Scopus" |
