Twenty-five-year follow-up among survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study

Rajen Mody, Suwen Li, Douglas C. Dover, Stephen Sallan, Wendy Leisenring, Kevin C. Oeffinger, Yutaka Yasui, Leslie L. Robison, Joseph P. Neglia

Research output: Contribution to journalArticle

218 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)5515-5523
Number of pages9
JournalBlood
Volume111
Issue number12
DOIs
StatePublished - Jun 15 2008

Fingerprint Dive into the research topics of 'Twenty-five-year follow-up among survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study'. Together they form a unique fingerprint.

  • Cite this

    Mody, R., Li, S., Dover, D. C., Sallan, S., Leisenring, W., Oeffinger, K. C., Yasui, Y., Robison, L. L., & Neglia, J. P. (2008). Twenty-five-year follow-up among survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study. Blood, 111(12), 5515-5523. https://doi.org/10.1182/blood-2007-10-117150