Navigation Links
Childhood Leukemia Survivors Struggle With Long-Term Comorbidities
Date:3/31/2008

WASHINGTON, March 31 /PRNewswire-USNewswire/ -- Survival rates of childhood cancers, especially leukemia, have improved greatly in the past three decades, but survivors of this disease still seem to face many health and lifestyle challenges as young adults. Depending on the extent of their disease and treatment methods, many continue to struggle with one or more life-long medical conditions and decreased quality of life, according to a study prepublished online in Blood, the official journal of the American Society of Hematology.

Acute lymphoblastic leukemia (ALL) is the most common childhood leukemia and childhood cancer overall, accounting for about one-fourth of all pediatric cancers. Each year about 3,000 new cases are diagnosed in the U.S., though recently the cure rate has improved and the estimated five-year survival rate is now greater than 80 percent. While therapies for the disease are generally very effective, previous studies have shown that survivors still face challenges with ongoing chronic health conditions and overall quality of life.

The population evaluated in this study was part of the Childhood Cancer Survivor Study (CCSS), a National Cancer Institute (NCI) funded, multi-institutional cohort, the largest comprehensive research cohort of long-term childhood cancer survivors. Of the 5,778 ALL survivors in the cohort, 4,151 (86 percent) completed questionnaires to evaluate rates of comorbidities, multiple chronic conditions, and other health markers, as well as lifestyle factors including marriage, education, employment, and health insurance coverage. For comparison, the study also evaluated the survivors' siblings with similar questionnaires.

In addition to self-reported effects up to 25 years post-diagnosis, the study also assessed the treatment regimens and disease relapse to understand how these factors might have long-term effects on survivors' quality of life. Specifically, the team compared patients who had received radiation therapy (RT) as part of their ALL therapy regimen (62 percent) with those who did not, as well as with those with or without recurrences within the first five years after original diagnosis.

"Children diagnosed with ALL are exposed to significant therapeutic intervention very early in their lives," said Dr. Rajen Mody, of the Department of Pediatrics, University of Michigan, and lead author of the study. "Looking at such a large cohort of long-term survivors, we sought to understand the real latent effects of aggressive cancer treatments and what specific factors could affect various health outcomes and quality of life by adulthood."

The analysis found that for the five-year ALL survivors, the survival at 25 years was 87 percent, and treatment method as well as relapse status seemed to affect survival. Survivors treated with RT had an overall survival of 87 percent compared with 96 percent for those without RT, and overall survival in those who relapsed within the first five years after diagnosis was just 63 percent compared with 93 percent for those who did not relapse early.

With regard to related health conditions, at least half of survivors reported one or more chronic medical conditions (cumulative incidence of 65 percent), compared with only 38 percent of their siblings. Importantly, survivors were 3.7 times more likely to have a severe or life-threatening medical condition and 2.8 times more likely to suffer from multiple chronic conditions than their siblings. These most often included musculoskeletal, cardiac, and neurological conditions. Significantly more survivors experienced poorer health, mental health problems, activity limitations, and functional impairment as compared with their siblings.

Again, RT and relapse status affected survivors' risk of chronic disease; patients with RT or an early relapse experienced higher rates of chronic or life-threatening conditions than non-RT, non-relapsed survivors. For example, the cumulative incidence of severe, life-threatening chronic conditions was 23 percent for RT survivors, compared with just 13 percent for non-RT survivors.

Survivors' social and economic outcomes, including rates of marriage, college graduation, and health insurance coverage, were also significantly lower than those of their siblings. Both female and male survivors were more likely to be unemployed than their siblings, though only in the females were the differences statistically significant. Most socioeconomic factors were not affected by relapse status, with the exception of male employment rates. However, RT seemed to affect these outcomes, as female RT survivors reported significantly lower rates of marriage, college graduation, and health insurance coverage than non-RT female survivors. Male RT survivors also reported lower rates of education attainment compared with non-RT survivors.

"Our findings suggest that the vast majority of the children with ALL who survive five years from the time of diagnosis are likely to be long-term survivors. Survivors treated without radiation therapy who did not relapse appear to have health outcomes and quality of life similar to the general population. However, survivors who have suffered a relapse of the disease or who have been treated with radiation therapy continue to fight with excess comorbidities and poor socioeconomic outcomes for many years following therapy, and it is important that we educate the patients, families, and their physicians about these long-term issues," said Dr. Mody. "As therapeutic interventions improve and more children beat leukemia, it's important to work toward not only higher survival rates, but also improved overall wellness."

The American Society of Hematology (http://www.hematology.org) is the world's largest professional society concerned with the causes and treatment of blood disorders. Its mission is to further the understanding, diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems, by promoting research, clinical care, education, training, and advocacy in hematology.


'/>"/>
SOURCE American Society of Hematology
Copyright©2008 PR Newswire.
All rights reserved

Related medicine news :

1. EnergyNow! Announces New Grant Funding to Combat Childhood Obesity
2. U.S. Surgeon General to Keynote Special Childhood Obesity Prevention Presentation in Philadelphia
3. More Vitamin D in Childhood Cuts Later Diabetes Risk
4. NIH awards NYU College of Dentistry $1.8M to identify risk for severe early childhood caries
5. Blue Cross and Blue Shield of Illinois Announces Campaign to Address Childhood Obesity
6. St. Jude finds signaling system that halts the growth of a childhood brain cancer
7. The ABCs of childhood zs: Snoring may be chronic despite surgery
8. Continuous Doctor Care Key to Childhood Screenings
9. UF researchers warn parents about dangers of childhood foot burns
10. Southern California Parents and Kids Take Healthy Steps in Tackling Childhood Obesity
11. In Early Childhood, Continuous Care by One Doctor Improves Delivery of Health Screenings
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/23/2017)... ... August 23, 2017 , ... MobilityWorks ®, ... named to the 2017 Inc. 500|5000, an exclusive ranking of America’s fastest-growing private ... of 139 percent, marking the twelfth year that the company has been included ...
(Date:8/23/2017)... ... August 23, 2017 , ... The non-profit ... holding an inaugural State of the Science Symposium in partnership with the Global ... 2017. , This symposium provides a forum for global leaders in human nutrition ...
(Date:8/22/2017)... , ... August 22, 2017 , ... ... pleased to announce the addition of Zack Tisch as the firm’s new Consulting ... KLAS-ranked healthcare IT consulting firm’s national accounts, from assisting clients with initial vendor ...
(Date:8/22/2017)... ... August 22, 2017 , ... “To Walk Away”: ... a B17 bomber named Edward Koontz. “To Walk Away” is the creation of published ... has published over two hundred manuscripts in chemistry and religion, as well as four ...
(Date:8/22/2017)... ... August 22, 2017 , ... ... the Founder and Managing Member for t4 Leadership Development & Consulting. He has ... his definition of “success”: physician leadership development, servant leadership, data driven process improvement, ...
Breaking Medicine News(10 mins):
(Date:8/15/2017)... -- AOTI Inc. announced today that its fully owned USA ... New York City Office in Yonkers, New York ... Oxygen (TWO 2 ) homecare therapy. This new East Coast location ... (ACHC) under the company,s DMEPOS accreditation for Home/Durable Medical Equipment Services. ... Advanced Oxygen Therapy Inc. ...
(Date:8/10/2017)... -- Physical Rehabilitation Network (PRN), acquired the long-standing outpatient rehabilitation clinic, ... . The reputable clinic will continue to be co-owned and ... staff of four clinicians. Lipkin received his doctorate in physical ... years of experience with a strong background in manual therapy. ... 10th PRN clinic in and around the Denver ...
(Date:8/7/2017)... 7, 2017 Insightin Health, provider of ... and engagement, announced the selection of Michael ... Development, effective as of February 2017. In this role, ... strategy for our clients. Wood brings with him ... and business analytics within the healthcare industry. Wood ...
Breaking Medicine Technology: