Late outcomes of adult survivors of childhood non-Hodgkin lymphoma: A report from the St. Jude Lifetime Cohort Study

Matthew J. Ehrhardt, John T. Sandlund, Nan Zhang, Wei Liu, Kirsten K. Ness, Nickhill Bhakta, Wassim Chemaitilly, Kevin R. Krull, Tara M. Brinkman, Deborah B. Crom, Larry Kun, Sue C. Kaste, Gregory T. Armstrong, Daniel M. Green, Kumar Srivastava, Leslie L. Robison, Melissa M. Hudson, Daniel A. Mulrooney

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background: Survivors of childhood non-Hodgkin lymphoma (NHL) are at increased risk for chronic health conditions. The objective of this study was to characterize health conditions, neurocognitive function, and physical performance among a clinically evaluated cohort of 200 childhood NHL survivors. Method: Chronic health and neurocognitive conditions were graded as per a modified version of the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) and impaired physical function defined as performance < 10th percentile of normative data. Multivariable regression was used to investigate associations between sociodemographic characteristics, therapeutic exposures, and outcomes. Results: Survivors were a median age of 10 years (range 1–19) at diagnosis and 34 years (range 20–58) at evaluation. Eighty-eight (44%) received radiation, 46 (23%) cranial radiation, and 69 (35%) high-dose methotrexate. Most prevalent CTCAE Grades 3–4 (severe life-threatening) conditions were obesity (35%), hypertension (9%), and impairment of executive function (13%), attention (9%), and memory (4%). Many had impaired strength (48%), flexibility (39%), muscular endurance (36%), and mobility (36%). Demographic and treatment-related factors were associated with the development of individual chronic diseases and functional deficits. Conclusions: Clinical evaluation identified a high prevalence of chronic health conditions, neurocognitive deficits, and performance limitations in childhood NHL survivors.

Original languageEnglish (US)
Article numbere26338
JournalPediatric Blood and Cancer
Volume64
Issue number6
DOIs
StatePublished - Jun 2017

Keywords

  • chronic health conditions
  • late effects
  • neurocognitive
  • non-Hodgkin lymphoma
  • survivorship

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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    Ehrhardt, M. J., Sandlund, J. T., Zhang, N., Liu, W., Ness, K. K., Bhakta, N., Chemaitilly, W., Krull, K. R., Brinkman, T. M., Crom, D. B., Kun, L., Kaste, S. C., Armstrong, G. T., Green, D. M., Srivastava, K., Robison, L. L., Hudson, M. M., & Mulrooney, D. A. (2017). Late outcomes of adult survivors of childhood non-Hodgkin lymphoma: A report from the St. Jude Lifetime Cohort Study. Pediatric Blood and Cancer, 64(6), [e26338]. https://doi.org/10.1002/pbc.26338