scholarly journals Long-term risk for subsequent leukemia after treatment for childhood cancer: a report from the Childhood Cancer Survivor Study

Blood ◽  
2011 ◽  
Vol 117 (23) ◽  
pp. 6315-6318 ◽  
Author(s):  
Kerri Nottage ◽  
Jennifer Lanctot ◽  
Zhenghong Li ◽  
Joseph P. Neglia ◽  
Smita Bhatia ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
Myeloid Leukemia ◽  
Childhood Cancer Survivor ◽  
Primary Therapy ◽  
Increased Risk ◽  
Childhood Cancer Survivor Study ◽  
Acute Myeloid

Abstract Previous investigations of cancer survivors report that the cumulative incidence of subsequent leukemia plateaus between 10 and 15 years after primary therapy. Risk beyond 15 years has not been comprehensively assessed, primarily because of lack of long-term follow-up. Among 5-year survivors from the Childhood Cancer Survivor Study cohort, 13 pathologically confirmed cases of subsequent leukemia occurred ≥ 15 years after primary malignancy, with a mean latency of 21.6 years (range, 15-32 years). Seven were acute myeloid leukemia (2 acute promyelocytic leukemia with t(15;17), 2 with confirmed preceding myelodysplastic syndrome), 4 acute lymphoblastic leukemia (2 pre-B lineage, 1 T cell, 1 unknown), and 2 other. Two acute myeloid leukemia cases had the 7q− deletion. The standardized incidence ratio was 3.5 (95% confidence interval, 1.9-6.0). Median survival from diagnosis of subsequent leukemia was 2 years. This is the first description of a statistically significant increased risk of subsequent leukemia ≥ 15 years from primary diagnosis of childhood cancer.

scholarly journals Long-Term Neurocognitive and Psychosocial Outcomes After Acute Myeloid Leukemia: A Childhood Cancer Survivor Study Report

2020 ◽  
Author(s):  
Kristen J Stefanski ◽  
Julia S Anixt ◽  
Pamela Goodman ◽  
Katherine Bowers ◽  
Wendy Leisenring ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Cancer Survivor ◽  
Myeloid Leukemia ◽  
Psychosocial Outcomes ◽  
Childhood Cancer Survivor ◽  
Increased Risk ◽  
Childhood Cancer Survivor Study ◽  
Acute Myeloid

Abstract Background Survivors of childhood acute myeloid leukemia (AML) are vulnerable to medical late effects of treatment; however, less is known about their psychosocial outcomes. This study evaluated neurocognitive and psychosocial outcomes in long-term AML survivors treated with bone marrow transplantation (BMT) or intensive chemotherapy (IC) without BMT. Methods AML survivors (N = 482; median age at diagnosis = 8 [range = 0-20] years; median age at evaluation = 30 [range = 18-49] years) treated with BMT (n = 183) or IC (n = 299) and sibling controls (N = 3190; median age at evaluation = 32 [range = 18-58] years) from the Childhood Cancer Survivor Study were compared on emotional distress (Brief Symptom Inventory-18), neurocognitive problems (Childhood Cancer Survivor Study Neurocognitive Questionnaire), health-related quality of life (SF-36), and social attainment. Outcomes were dichotomized (impaired vs nonimpaired) using established criteria, and relative risks (RRs) were estimated with multivariable Poisson regression, adjusted for age at evaluation and sex. Results AML survivors were more likely than siblings to report impairment in overall emotional (RR = 2.19, 95% confidence interval [CI] = 1.51 to 3.18), neurocognitive (RR = 2.03, 95% CI = 1.47 to 2.79), and physical quality of life (RR = 2.71, 95% CI = 1.61 to 4.56) outcomes. Survivors were at increased risk for lower education (RR = 1.15, 95% CI = 1.03 to 1.30), unemployment (RR = 1.41, 95% CI = 1.16 to 1.71), lower income (RR = 1.39, 95% CI = 1.17 to 1.65), and not being married or having a partner (RR = 1.33, 95% CI = 1.17 to 1.51). BMT-treated survivors did not differ statistically significantly from IC-treated on any outcome measure. Conclusions AML survivors are at increased risk for psychosocial impairment compared with siblings; however, BMT does not confer additional risk for psychosocial late effects compared with treatment without BMT.

scholarly journals Health Behaviors, Medical Care, and Interventions to Promote Healthy Living in the Childhood Cancer Survivor Study Cohort

2009 ◽  
Vol 27 (14) ◽  
pp. 2363-2373 ◽  
Author(s):  
Paul C. Nathan ◽  
Jennifer S. Ford ◽  
Tara O. Henderson ◽  
Melissa M. Hudson ◽  
Karen M. Emmons ◽  
...  
Keyword(s):  
Health Behaviors ◽  
Medical Care ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
Late Effects ◽  
Healthy Lifestyle ◽  
Childhood Cancer Survivor ◽  
Increased Risk ◽  
Childhood Cancer Survivor Study

Childhood cancer survivors are at risk for medical and psychosocial late effects as a result of their cancer and its therapy. Promotion of healthy lifestyle behaviors and provision of regular risk-based medical care and surveillance may modify the evolution of these late effects. This manuscript summarizes publications from the Childhood Cancer Survivor Study (CCSS) that have examined health behaviors, risk-based health care, and interventions to promote healthy lifestyle practices. Long-term survivors use tobacco and alcohol and have inactive lifestyles at higher rates than is ideal given their increased risk of cardiac, pulmonary, and metabolic late effects. Nearly 90% of survivors report receiving some form of medical care. However, only 18% report medical visits related to their prior cancer that include discussion or ordering of screening tests or counseling on how to reduce the specific risks arising from their cancer. One low-cost, peer-driven intervention trial has been successful in improving smoking cessation within the CCSS cohort. On the basis of data from CCSS investigations, several trials to promote improved medical surveillance among high-risk groups within the cohort are underway. Despite their long-term risks, many survivors of childhood cancer engage in risky health behaviors and do not receive adequate risk-based medical care.

scholarly journals Long-term auditory complications after childhood cancer: A report from the Swiss Childhood Cancer Survivor Study

2016 ◽  
Vol 64 (2) ◽  
pp. 364-373 ◽  
Author(s):  
Annette Weiss ◽  
Grit Sommer ◽  
Rahel Kasteler ◽  
Katrin Scheinemann ◽  
Michael Grotzer ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Cancer Survivor ◽  
Childhood Cancer Survivor ◽  
Childhood Cancer Survivor Study

scholarly journals Behavioral, Social, and Emotional Symptom Comorbidities and Profiles in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

2016 ◽  
Vol 34 (28) ◽  
pp. 3417-3425 ◽  
Author(s):  
Tara M. Brinkman ◽  
Chenghong Li ◽  
Kathryn Vannatta ◽  
Jordan G. Marchak ◽  
Jin-Shei Lai ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Cancer Survivor ◽  
Late Effects ◽  
Externalizing Symptoms ◽  
Attention Problems ◽  
Childhood Cancer Survivor ◽  
Symptom Profiles ◽  
Increased Risk ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

Purpose In the general population, psychological symptoms frequently co-occur; however, profiles of symptom comorbidities have not been examined among adolescent survivors of childhood cancer. Patients and Methods Parents of 3,893 5-year survivors of childhood cancer who were treated between 1970 and 1999 and who were assessed in adolescence (age 12 to 17 years) completed the Behavior Problems Index. Age- and sex-standardized z scores were calculated for symptom domains by using the Childhood Cancer Survivor Study sibling cohort. Latent profile analysis identified profiles of comorbid symptoms, and multivariable multinomial logistic regression modeling examined associations between cancer treatment exposures and physical late effects and identified symptom profiles. Odds ratios (ORs) and 95% CIs for latent class membership were estimated and analyses were stratified by cranial radiation therapy (CRT; CRT or no CRT). Results Four symptoms profiles were identified: no significant symptoms (CRT, 63%; no CRT, 70%); elevated anxiety and/or depression, social withdrawal, and attention problems (internalizing; CRT, 31%; no CRT, 16%); elevated headstrong behavior and attention problems (externalizing; CRT, no observed; no CRT, 9%); and elevated internalizing and externalizing symptoms (global symptoms; CRT, 6%; no CRT, 5%). Treatment with ≥ 30 Gy CRT conferred greater risk of internalizing (OR, 1.7; 95% CI, 1.0 to 2.8) and global symptoms (OR, 3.2; 95% CI, 1.2 to 8.4). Among the no CRT group, corticosteroid treatment was associated with externalizing symptoms (OR, 1.9; 95% CI, 1.2 to 2.8) and ≥ 4.3 g/m2 intravenous methotrexate exposure was associated with global symptoms (OR, 1.5; 95% CI, 0.9 to 2.4). Treatment late effects, including obesity, cancer-related pain, and sensory impairments, were significantly associated with increased risk of comorbid symptoms. Conclusion Behavioral, emotional, and social symptoms frequently co-occur in adolescent survivors of childhood cancer and are associated with treatment exposures and physical late effects. Assessment and consideration of symptom profiles are essential for directing appropriate mental health treatment for adolescent survivors.

scholarly journals Neurocognitive status in long-term survivors of childhood CNS malignancies: A report from the Childhood Cancer Survivor Study.

2009 ◽  
Vol 23 (6) ◽  
pp. 705-717 ◽  
Author(s):  
Leah Ellenberg ◽  
Qi Liu ◽  
Gerard Gioia ◽  
Yutaka Yasui ◽  
Roger J. Packer ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Cancer Survivor ◽  
Childhood Cancer Survivor ◽  
Childhood Cancer Survivor Study ◽  
Long Term Survivors ◽  
Cns Malignancies
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