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

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 surviv
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SOURCE American Society of Hematology
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