Late effects of treatment in survivors of childhood acute myeloid leukemia

Wing Leung, Melissa M. Hudson, Donald K. Strickland, Sean Phipps, Deo K. Srivastava, Raul C. Ribeiro, Jeffrey E. Rubnitz, John T. Sandlund, Larry E. Kun, Laura C. Bowman, Bowman I. Razzouk, Prasad Mathew, Patricia Shearer, William E. Evans, Ching Hon Pui

Research output: Contribution to journalArticle

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Abstract

Purpose: To investigate the incidence of and risk factors for late sequelae of treatment in patients who survived for more than 10 years after the diagnosis of childhood acute myeloid leukemia (AML). Patients and Methods: Of 77 survivors (median follow-up duration, 16.7 years), 44 (group A) had received chemotherapy, 18 (group B) had received chemotherapy and cranial irradiation, and 15 (group C) had received chemotherapy, total-body irradiation, and allogeneic bone marrow transplantation. Late complications, tobacco use, and health insurance status were assessed. Results: Growth abnormalities were found in 51% of survivors, neurocognitive abnormalities in 30%, transfusion-acquired hepatitis in 28%, endocrine abnormalities in 16%, cataracts in 12%, and cardiac abnormalities in 8%. Younger age at the time of diagnosis or initiation of radiation therapy, higher dose of radiation, and treatment in groups B and C were risk factors for the development of academic difficulties and greater decrease in height Z score. In addition, treatment in group C was a risk factor for a greater decrease in weight Z score and the development of growth-hormone deficiency, hypothyroidism, hypogonadism, infertility, and cataracts. The estimated cumulative risk of a second malignancy at 20 years after diagnosis was 1.8% (95% confidence interval, 0.3% to 11.8%). Twenty-two patients (29%) were smokers, and 11 (14%) had no medical insurance at the time of last follow-up. Conclusion: Late sequelae are common in long-term survivors of childhood AML. Our findings should be useful in defining areas for surveillance of and intervention for late sequelae and in assessing the risk of individual late effects on the basis of age and history of treatment. (C) 2000 by American Society of Clinical Oncology.

Original languageEnglish (US)
Pages (from-to)3273-3279
Number of pages7
JournalJournal of Clinical Oncology
Volume18
Issue number18
DOIs
StatePublished - Sep 15 2000

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Acute Myeloid Leukemia
Survivors
Drug Therapy
Cataract
Cranial Irradiation
Insurance Coverage
Hypogonadism
Second Primary Neoplasms
Whole-Body Irradiation
Homologous Transplantation
Tobacco Use
Therapeutics
Health Insurance
Hypothyroidism
Insurance
Bone Marrow Transplantation
Infertility
Hepatitis
Growth Hormone
Health Status

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Leung, W., Hudson, M. M., Strickland, D. K., Phipps, S., Srivastava, D. K., Ribeiro, R. C., ... Pui, C. H. (2000). Late effects of treatment in survivors of childhood acute myeloid leukemia. Journal of Clinical Oncology, 18(18), 3273-3279. https://doi.org/10.1200/JCO.2000.18.18.3273

Late effects of treatment in survivors of childhood acute myeloid leukemia. / Leung, Wing; Hudson, Melissa M.; Strickland, Donald K.; Phipps, Sean; Srivastava, Deo K.; Ribeiro, Raul C.; Rubnitz, Jeffrey E.; Sandlund, John T.; Kun, Larry E.; Bowman, Laura C.; Razzouk, Bowman I.; Mathew, Prasad; Shearer, Patricia; Evans, William E.; Pui, Ching Hon.

In: Journal of Clinical Oncology, Vol. 18, No. 18, 15.09.2000, p. 3273-3279.

Research output: Contribution to journalArticle

Leung, W, Hudson, MM, Strickland, DK, Phipps, S, Srivastava, DK, Ribeiro, RC, Rubnitz, JE, Sandlund, JT, Kun, LE, Bowman, LC, Razzouk, BI, Mathew, P, Shearer, P, Evans, WE & Pui, CH 2000, 'Late effects of treatment in survivors of childhood acute myeloid leukemia', Journal of Clinical Oncology, vol. 18, no. 18, pp. 3273-3279. https://doi.org/10.1200/JCO.2000.18.18.3273
Leung W, Hudson MM, Strickland DK, Phipps S, Srivastava DK, Ribeiro RC et al. Late effects of treatment in survivors of childhood acute myeloid leukemia. Journal of Clinical Oncology. 2000 Sep 15;18(18):3273-3279. https://doi.org/10.1200/JCO.2000.18.18.3273
Leung, Wing ; Hudson, Melissa M. ; Strickland, Donald K. ; Phipps, Sean ; Srivastava, Deo K. ; Ribeiro, Raul C. ; Rubnitz, Jeffrey E. ; Sandlund, John T. ; Kun, Larry E. ; Bowman, Laura C. ; Razzouk, Bowman I. ; Mathew, Prasad ; Shearer, Patricia ; Evans, William E. ; Pui, Ching Hon. / Late effects of treatment in survivors of childhood acute myeloid leukemia. In: Journal of Clinical Oncology. 2000 ; Vol. 18, No. 18. pp. 3273-3279.
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abstract = "Purpose: To investigate the incidence of and risk factors for late sequelae of treatment in patients who survived for more than 10 years after the diagnosis of childhood acute myeloid leukemia (AML). Patients and Methods: Of 77 survivors (median follow-up duration, 16.7 years), 44 (group A) had received chemotherapy, 18 (group B) had received chemotherapy and cranial irradiation, and 15 (group C) had received chemotherapy, total-body irradiation, and allogeneic bone marrow transplantation. Late complications, tobacco use, and health insurance status were assessed. Results: Growth abnormalities were found in 51{\%} of survivors, neurocognitive abnormalities in 30{\%}, transfusion-acquired hepatitis in 28{\%}, endocrine abnormalities in 16{\%}, cataracts in 12{\%}, and cardiac abnormalities in 8{\%}. Younger age at the time of diagnosis or initiation of radiation therapy, higher dose of radiation, and treatment in groups B and C were risk factors for the development of academic difficulties and greater decrease in height Z score. In addition, treatment in group C was a risk factor for a greater decrease in weight Z score and the development of growth-hormone deficiency, hypothyroidism, hypogonadism, infertility, and cataracts. The estimated cumulative risk of a second malignancy at 20 years after diagnosis was 1.8{\%} (95{\%} confidence interval, 0.3{\%} to 11.8{\%}). Twenty-two patients (29{\%}) were smokers, and 11 (14{\%}) had no medical insurance at the time of last follow-up. Conclusion: Late sequelae are common in long-term survivors of childhood AML. Our findings should be useful in defining areas for surveillance of and intervention for late sequelae and in assessing the risk of individual late effects on the basis of age and history of treatment. (C) 2000 by American Society of Clinical Oncology.",
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T1 - Late effects of treatment in survivors of childhood acute myeloid leukemia

AU - Leung, Wing

AU - Hudson, Melissa M.

AU - Strickland, Donald K.

AU - Phipps, Sean

AU - Srivastava, Deo K.

AU - Ribeiro, Raul C.

AU - Rubnitz, Jeffrey E.

AU - Sandlund, John T.

AU - Kun, Larry E.

AU - Bowman, Laura C.

AU - Razzouk, Bowman I.

AU - Mathew, Prasad

AU - Shearer, Patricia

AU - Evans, William E.

AU - Pui, Ching Hon

PY - 2000/9/15

Y1 - 2000/9/15

N2 - Purpose: To investigate the incidence of and risk factors for late sequelae of treatment in patients who survived for more than 10 years after the diagnosis of childhood acute myeloid leukemia (AML). Patients and Methods: Of 77 survivors (median follow-up duration, 16.7 years), 44 (group A) had received chemotherapy, 18 (group B) had received chemotherapy and cranial irradiation, and 15 (group C) had received chemotherapy, total-body irradiation, and allogeneic bone marrow transplantation. Late complications, tobacco use, and health insurance status were assessed. Results: Growth abnormalities were found in 51% of survivors, neurocognitive abnormalities in 30%, transfusion-acquired hepatitis in 28%, endocrine abnormalities in 16%, cataracts in 12%, and cardiac abnormalities in 8%. Younger age at the time of diagnosis or initiation of radiation therapy, higher dose of radiation, and treatment in groups B and C were risk factors for the development of academic difficulties and greater decrease in height Z score. In addition, treatment in group C was a risk factor for a greater decrease in weight Z score and the development of growth-hormone deficiency, hypothyroidism, hypogonadism, infertility, and cataracts. The estimated cumulative risk of a second malignancy at 20 years after diagnosis was 1.8% (95% confidence interval, 0.3% to 11.8%). Twenty-two patients (29%) were smokers, and 11 (14%) had no medical insurance at the time of last follow-up. Conclusion: Late sequelae are common in long-term survivors of childhood AML. Our findings should be useful in defining areas for surveillance of and intervention for late sequelae and in assessing the risk of individual late effects on the basis of age and history of treatment. (C) 2000 by American Society of Clinical Oncology.

AB - Purpose: To investigate the incidence of and risk factors for late sequelae of treatment in patients who survived for more than 10 years after the diagnosis of childhood acute myeloid leukemia (AML). Patients and Methods: Of 77 survivors (median follow-up duration, 16.7 years), 44 (group A) had received chemotherapy, 18 (group B) had received chemotherapy and cranial irradiation, and 15 (group C) had received chemotherapy, total-body irradiation, and allogeneic bone marrow transplantation. Late complications, tobacco use, and health insurance status were assessed. Results: Growth abnormalities were found in 51% of survivors, neurocognitive abnormalities in 30%, transfusion-acquired hepatitis in 28%, endocrine abnormalities in 16%, cataracts in 12%, and cardiac abnormalities in 8%. Younger age at the time of diagnosis or initiation of radiation therapy, higher dose of radiation, and treatment in groups B and C were risk factors for the development of academic difficulties and greater decrease in height Z score. In addition, treatment in group C was a risk factor for a greater decrease in weight Z score and the development of growth-hormone deficiency, hypothyroidism, hypogonadism, infertility, and cataracts. The estimated cumulative risk of a second malignancy at 20 years after diagnosis was 1.8% (95% confidence interval, 0.3% to 11.8%). Twenty-two patients (29%) were smokers, and 11 (14%) had no medical insurance at the time of last follow-up. Conclusion: Late sequelae are common in long-term survivors of childhood AML. Our findings should be useful in defining areas for surveillance of and intervention for late sequelae and in assessing the risk of individual late effects on the basis of age and history of treatment. (C) 2000 by American Society of Clinical Oncology.

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