Twenty years of follow-up among survivors of childhood and young adult acute myeloid leukemia: A report from the Childhood Cancer Survivor Study Journal Article


Authors: Mulrooney, D. A.; Dover, D. C.; Li, S.; Yasui, Y.; Ness, K. K.; Mertens, A. C.; Neglia, J. P.; Sklar, C. A.; Robison, L. L.; Davies, S. M.; Hudson, M.; Armstrong, G.; Perkins, J.; O'Leary, M.; Friedman, D.; Pendergrass, T.; Greffe, B.; Odom, L.; Ruccione, K.; Mulvihill, J.; Ginsberg, J.; Meadows, A.; Tersak, J.; Ritchey, A. K.; Blatt, J.; Reaman, G.; Packer, R.; Davies, S.; Bhatia, S.; Qualman, S.; Hammond, S.; Termuhlen, A.; Ruymann, F.; Diller, L.; Grier, H.; Li, F.; Meacham, L.; Mertens, A.; Leisenring, W.; Potter, J.; Greenberg, M.; Nathan, P. C.; Boice, J.; Rodriguez, V.; Smithson, W. A.; Gilchrist, G.; Sklar, C.; Oeffinger, K.; Finklestein, J.; Anderson, B.; Inskip, P.; Vik, T. A.; Weetman, R.; Green, D. M.; Hayashi, R.; Vietti, T.; Marina, N.; Donaldson, S. S.; Link, M. P.; Dreyer, Z.; Whelan, K.; Sande, J.; Berkow, R.; Casallis, J.; Zeltzer, L.; Goldsby, R.; Ablin, A.; Hutchinson, R.; Neglia, J.; Deapen, D.; Breslow, N.; Bowers, D.; Tomlinson, G.; Buchanan, G. R.; Strong, L.; Stovall, M.
Article Title: Twenty years of follow-up among survivors of childhood and young adult acute myeloid leukemia: A report from the Childhood Cancer Survivor Study
Abstract: BACKGROUND. Limited data exist on the comprehensive assessment of late medical and social effects experienced by survivors of childhood and young adult acute myeloid leukemia (AML). METHODS. This analysis included 272 5-year AML survivors who participated in the Childhood Cancer Survivor Study (CCSS). All patients were diagnosed at age ≤21 years between the years 1970 and 1986, and none underwent stem cell transplantation. Rates of survival, relapse, and late outcomes were analyzed. RESULTS. The average follow-up was 20.5 years (range, 5-33 years). The overall survival rate was 97% at 10 years (95% confidence interval [95%CI], 94%-98%) and 94% at 20 years (95% CI, 90%-96%). Six survivors reported 8 recurrences. The cumulative incidence of recurrent AML was 6.6% at 10 years (95% CI, 3.7%-9.6%) and 8.6% at 20 years (95% CI, 5.1%-12.1%). Ten subsequent malignant neoplasms (SMN) were reported, including 4 with a history of radiation therapy, for a 20-year cumulative incidence of 1.7% (95% CI, 0.02%-3.4%). Six cardiac events were reported, for a 20-year cumulative incidence 4.7% (95% CI, 2.1%-7.3%). Half of the survivors reported a chronic medical condition and, compared with siblings, were at increased risk for severe or life-threatening chronic medical conditions (16% vs 5.8%; P < .001). Among those aged ≥25 years, the age-adjusted marriage rates were similar among survivors and the general United States population (57% for both) and lower compared with siblings (67%; P < .01). Survivors' college graduation rates were lower compared with siblings but higher than the general population (40% vs 52% vs 34%, respectively; P < .01). Employment rates were similar between survivors, siblings, and the general population (93%, 97.6%, and 95.8%, respectively). CONCLUSIONS. Long-term survival from childhood AML ≥5-years after diagnosis was favorable. Late-occurring medical events remained a concern with socioeconomic achievement lower than expected within the individual family unit, although it was not different from the general United States population. © 2008 American Cancer Society.
Keywords: adolescent; adult; cancer survival; child; preschool child; aged; child, preschool; middle aged; survival rate; acute granulocytic leukemia; major clinical study; leukemia, myeloid, acute; mortality; cancer recurrence; united states; cancer patient; outcome assessment; follow up; follow-up studies; cancer incidence; survivor; risk assessment; survivors; chronic disease; health insurance; disease severity; infant; infant, newborn; newborn; survivorship; malignant neoplastic disease; sibling; educational status; marriage; childhood leukemia; leukemia relapse; insurance, health; employment; acute myeloid leukemia; medical late effects; social late effects
Journal Title: Cancer
Volume: 112
Issue: 9
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2008-05-01
Start Page: 2071
End Page: 2079
Language: English
DOI: 10.1002/cncr.23405
PUBMED: 18327823
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 29" - "Export Date: 17 November 2011" - "CODEN: CANCA" - "Source: Scopus"
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MSK Authors
  1. Charles A Sklar
    303 Sklar
  2. Kevin Oeffinger
    286 Oeffinger