Twenty years of follow-up among survivors of childhood and young adult acute myeloid leukemia: A report from the Childhood Cancer Survivor Study

Daniel A. Mulrooney, Douglas C. Dover, Suwen Li, Yutaka Yasui, Kirsten K. Ness, Ann C. Mertens, Joseph P. Neglia, Charles A. Sklar, Leslie L. Robison, Stella M. Davies, Melissa Hudson, Greg Armstrong, Joanna Perkins, Maura O'Leary, Debra Friedman, Thomas Pendergrass, Brian Greffe, Lorrie Odom, Kathy Ruccione, John MulvihillJill Ginsberg, Anna Meadows, Jean Tersak, A. Kim Ritchey, Julie Blatt, Gregory Reaman, Roger Packer, Stella Davies, Smita Bhatia, Stephen Qualman, Sue Hammond, Amanda Termuhlen, Frederick Ruymann, Lisa Diller, Holcombe Grier, Frederick Li, Lillian Meacham, Ann Mertens, Wendy Leisenring, John Potter, Mark Greenberg, Paul C. Nathan, John Boice, Vilmarie Rodriguez, W. Anthony Smithson, Gerald Gilchrist, Charles Sklar, Kevin Oeffinger, Jerry Finklestein, Barry Anderson, Peter Inskip, Terry A. Vik, Robert Weetman, Daniel M. Green, Robert Hayashi, Teresa Vietti, Neyssa Marina, Sarah S. Donaldson, Michael P. Link, Zoann Dreyer, Kimberly Whelan, Jane Sande, Roger Berkow, Jackie Casallis, Lonnie Zeltzer, Robert Goldsby, Arthur Ablin, Raymond Hutchinson, Joseph Neglia, Dennis Deapen, Norman Breslow, Dan Bowers, Gail Tomlinson, George R. Buchanan, Louise Strong, Marilyn Stovall

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

BACKGROUND. Limited data exist on the comprehensive assessment of late medical and social effects experienced by survivors of childhood and young adult acute myeloid leukemia (AML). METHODS. This analysis included 272 5-year AML survivors who participated in the Childhood Cancer Survivor Study (CCSS). All patients were diagnosed at age ≤21 years between the years 1970 and 1986, and none underwent stem cell transplantation. Rates of survival, relapse, and late outcomes were analyzed. RESULTS. The average follow-up was 20.5 years (range, 5-33 years). The overall survival rate was 97% at 10 years (95% confidence interval [95%CI], 94%-98%) and 94% at 20 years (95% CI, 90%-96%). Six survivors reported 8 recurrences. The cumulative incidence of recurrent AML was 6.6% at 10 years (95% CI, 3.7%-9.6%) and 8.6% at 20 years (95% CI, 5.1%-12.1%). Ten subsequent malignant neoplasms (SMN) were reported, including 4 with a history of radiation therapy, for a 20-year cumulative incidence of 1.7% (95% CI, 0.02%-3.4%). Six cardiac events were reported, for a 20-year cumulative incidence 4.7% (95% CI, 2.1%-7.3%). Half of the survivors reported a chronic medical condition and, compared with siblings, were at increased risk for severe or life-threatening chronic medical conditions (16% vs 5.8%; P < .001). Among those aged ≥25 years, the age-adjusted marriage rates were similar among survivors and the general United States population (57% for both) and lower compared with siblings (67%; P < .01). Survivors' college graduation rates were lower compared with siblings but higher than the general population (40% vs 52% vs 34%, respectively; P < .01). Employment rates were similar between survivors, siblings, and the general population (93%, 97.6%, and 95.8%, respectively). CONCLUSIONS. Long-term survival from childhood AML ≥5-years after diagnosis was favorable. Late-occurring medical events remained a concern with socioeconomic achievement lower than expected within the individual family unit, although it was not different from the general United States population.

Original languageEnglish (US)
Pages (from-to)2071-2079
Number of pages9
JournalCancer
Volume112
Issue number9
DOIs
StatePublished - May 1 2008

Fingerprint

Acute Myeloid Leukemia
Survivors
Young Adult
Siblings
Neoplasms
Population
Incidence
Survival Rate
Recurrence
Stem Cell Transplantation
Marriage
Radiotherapy
Confidence Intervals
Survival

Keywords

  • Acute myeloid leukemia
  • Medical late effects
  • Social late effects
  • Survivorship

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Mulrooney, D. A., Dover, D. C., Li, S., Yasui, Y., Ness, K. K., Mertens, A. C., ... Stovall, M. (2008). Twenty years of follow-up among survivors of childhood and young adult acute myeloid leukemia: A report from the Childhood Cancer Survivor Study. Cancer, 112(9), 2071-2079. https://doi.org/10.1002/cncr.23405

Twenty years of follow-up among survivors of childhood and young adult acute myeloid leukemia : A report from the Childhood Cancer Survivor Study. / Mulrooney, Daniel A.; Dover, Douglas C.; Li, Suwen; Yasui, Yutaka; Ness, Kirsten K.; Mertens, Ann C.; Neglia, Joseph P.; Sklar, Charles A.; Robison, Leslie L.; Davies, Stella M.; Hudson, Melissa; Armstrong, Greg; Perkins, Joanna; O'Leary, Maura; Friedman, Debra; Pendergrass, Thomas; Greffe, Brian; Odom, Lorrie; Ruccione, Kathy; Mulvihill, John; Ginsberg, Jill; Meadows, Anna; Tersak, Jean; Ritchey, A. Kim; Blatt, Julie; Reaman, Gregory; Packer, Roger; Davies, Stella; Bhatia, Smita; Qualman, Stephen; Hammond, Sue; Termuhlen, Amanda; Ruymann, Frederick; Diller, Lisa; Grier, Holcombe; Li, Frederick; Meacham, Lillian; Mertens, Ann; Leisenring, Wendy; Potter, John; Greenberg, Mark; Nathan, Paul C.; Boice, John; Rodriguez, Vilmarie; Smithson, W. Anthony; Gilchrist, Gerald; Sklar, Charles; Oeffinger, Kevin; Finklestein, Jerry; Anderson, Barry; Inskip, Peter; Vik, Terry A.; Weetman, Robert; Green, Daniel M.; Hayashi, Robert; Vietti, Teresa; Marina, Neyssa; Donaldson, Sarah S.; Link, Michael P.; Dreyer, Zoann; Whelan, Kimberly; Sande, Jane; Berkow, Roger; Casallis, Jackie; Zeltzer, Lonnie; Goldsby, Robert; Ablin, Arthur; Hutchinson, Raymond; Neglia, Joseph; Deapen, Dennis; Breslow, Norman; Bowers, Dan; Tomlinson, Gail; Buchanan, George R.; Strong, Louise; Stovall, Marilyn.

In: Cancer, Vol. 112, No. 9, 01.05.2008, p. 2071-2079.

Research output: Contribution to journalArticle

Mulrooney, DA, Dover, DC, Li, S, Yasui, Y, Ness, KK, Mertens, AC, Neglia, JP, Sklar, CA, Robison, LL, Davies, SM, Hudson, M, Armstrong, G, Perkins, J, O'Leary, M, Friedman, D, Pendergrass, T, Greffe, B, Odom, L, Ruccione, K, Mulvihill, J, Ginsberg, J, Meadows, A, Tersak, J, Ritchey, AK, Blatt, J, Reaman, G, Packer, R, Davies, S, Bhatia, S, Qualman, S, Hammond, S, Termuhlen, A, Ruymann, F, Diller, L, Grier, H, Li, F, Meacham, L, Mertens, A, Leisenring, W, Potter, J, Greenberg, M, Nathan, PC, Boice, J, Rodriguez, V, Smithson, WA, Gilchrist, G, Sklar, C, Oeffinger, K, Finklestein, J, Anderson, B, Inskip, P, Vik, TA, Weetman, R, Green, DM, Hayashi, R, Vietti, T, Marina, N, Donaldson, SS, Link, MP, Dreyer, Z, Whelan, K, Sande, J, Berkow, R, Casallis, J, Zeltzer, L, Goldsby, R, Ablin, A, Hutchinson, R, Neglia, J, Deapen, D, Breslow, N, Bowers, D, Tomlinson, G, Buchanan, GR, Strong, L & Stovall, M 2008, 'Twenty years of follow-up among survivors of childhood and young adult acute myeloid leukemia: A report from the Childhood Cancer Survivor Study', Cancer, vol. 112, no. 9, pp. 2071-2079. https://doi.org/10.1002/cncr.23405
Mulrooney, Daniel A. ; Dover, Douglas C. ; Li, Suwen ; Yasui, Yutaka ; Ness, Kirsten K. ; Mertens, Ann C. ; Neglia, Joseph P. ; Sklar, Charles A. ; Robison, Leslie L. ; Davies, Stella M. ; Hudson, Melissa ; Armstrong, Greg ; Perkins, Joanna ; O'Leary, Maura ; Friedman, Debra ; Pendergrass, Thomas ; Greffe, Brian ; Odom, Lorrie ; Ruccione, Kathy ; Mulvihill, John ; Ginsberg, Jill ; Meadows, Anna ; Tersak, Jean ; Ritchey, A. Kim ; Blatt, Julie ; Reaman, Gregory ; Packer, Roger ; Davies, Stella ; Bhatia, Smita ; Qualman, Stephen ; Hammond, Sue ; Termuhlen, Amanda ; Ruymann, Frederick ; Diller, Lisa ; Grier, Holcombe ; Li, Frederick ; Meacham, Lillian ; Mertens, Ann ; Leisenring, Wendy ; Potter, John ; Greenberg, Mark ; Nathan, Paul C. ; Boice, John ; Rodriguez, Vilmarie ; Smithson, W. Anthony ; Gilchrist, Gerald ; Sklar, Charles ; Oeffinger, Kevin ; Finklestein, Jerry ; Anderson, Barry ; Inskip, Peter ; Vik, Terry A. ; Weetman, Robert ; Green, Daniel M. ; Hayashi, Robert ; Vietti, Teresa ; Marina, Neyssa ; Donaldson, Sarah S. ; Link, Michael P. ; Dreyer, Zoann ; Whelan, Kimberly ; Sande, Jane ; Berkow, Roger ; Casallis, Jackie ; Zeltzer, Lonnie ; Goldsby, Robert ; Ablin, Arthur ; Hutchinson, Raymond ; Neglia, Joseph ; Deapen, Dennis ; Breslow, Norman ; Bowers, Dan ; Tomlinson, Gail ; Buchanan, George R. ; Strong, Louise ; Stovall, Marilyn. / Twenty years of follow-up among survivors of childhood and young adult acute myeloid leukemia : A report from the Childhood Cancer Survivor Study. In: Cancer. 2008 ; Vol. 112, No. 9. pp. 2071-2079.
@article{28397284acf1470aaf5727cd0670dc6e,
title = "Twenty years of follow-up among survivors of childhood and young adult acute myeloid leukemia: A report from the Childhood Cancer Survivor Study",
abstract = "BACKGROUND. Limited data exist on the comprehensive assessment of late medical and social effects experienced by survivors of childhood and young adult acute myeloid leukemia (AML). METHODS. This analysis included 272 5-year AML survivors who participated in the Childhood Cancer Survivor Study (CCSS). All patients were diagnosed at age ≤21 years between the years 1970 and 1986, and none underwent stem cell transplantation. Rates of survival, relapse, and late outcomes were analyzed. RESULTS. The average follow-up was 20.5 years (range, 5-33 years). The overall survival rate was 97{\%} at 10 years (95{\%} confidence interval [95{\%}CI], 94{\%}-98{\%}) and 94{\%} at 20 years (95{\%} CI, 90{\%}-96{\%}). Six survivors reported 8 recurrences. The cumulative incidence of recurrent AML was 6.6{\%} at 10 years (95{\%} CI, 3.7{\%}-9.6{\%}) and 8.6{\%} at 20 years (95{\%} CI, 5.1{\%}-12.1{\%}). Ten subsequent malignant neoplasms (SMN) were reported, including 4 with a history of radiation therapy, for a 20-year cumulative incidence of 1.7{\%} (95{\%} CI, 0.02{\%}-3.4{\%}). Six cardiac events were reported, for a 20-year cumulative incidence 4.7{\%} (95{\%} CI, 2.1{\%}-7.3{\%}). Half of the survivors reported a chronic medical condition and, compared with siblings, were at increased risk for severe or life-threatening chronic medical conditions (16{\%} vs 5.8{\%}; P < .001). Among those aged ≥25 years, the age-adjusted marriage rates were similar among survivors and the general United States population (57{\%} for both) and lower compared with siblings (67{\%}; P < .01). Survivors' college graduation rates were lower compared with siblings but higher than the general population (40{\%} vs 52{\%} vs 34{\%}, respectively; P < .01). Employment rates were similar between survivors, siblings, and the general population (93{\%}, 97.6{\%}, and 95.8{\%}, respectively). CONCLUSIONS. Long-term survival from childhood AML ≥5-years after diagnosis was favorable. Late-occurring medical events remained a concern with socioeconomic achievement lower than expected within the individual family unit, although it was not different from the general United States population.",
keywords = "Acute myeloid leukemia, Medical late effects, Social late effects, Survivorship",
author = "Mulrooney, {Daniel A.} and Dover, {Douglas C.} and Suwen Li and Yutaka Yasui and Ness, {Kirsten K.} and Mertens, {Ann C.} and Neglia, {Joseph P.} and Sklar, {Charles A.} and Robison, {Leslie L.} and Davies, {Stella M.} and Melissa Hudson and Greg Armstrong and Joanna Perkins and Maura O'Leary and Debra Friedman and Thomas Pendergrass and Brian Greffe and Lorrie Odom and Kathy Ruccione and John Mulvihill and Jill Ginsberg and Anna Meadows and Jean Tersak and Ritchey, {A. Kim} and Julie Blatt and Gregory Reaman and Roger Packer and Stella Davies and Smita Bhatia and Stephen Qualman and Sue Hammond and Amanda Termuhlen and Frederick Ruymann and Lisa Diller and Holcombe Grier and Frederick Li and Lillian Meacham and Ann Mertens and Wendy Leisenring and John Potter and Mark Greenberg and Nathan, {Paul C.} and John Boice and Vilmarie Rodriguez and Smithson, {W. Anthony} and Gerald Gilchrist and Charles Sklar and Kevin Oeffinger and Jerry Finklestein and Barry Anderson and Peter Inskip and Vik, {Terry A.} and Robert Weetman and Green, {Daniel M.} and Robert Hayashi and Teresa Vietti and Neyssa Marina and Donaldson, {Sarah S.} and Link, {Michael P.} and Zoann Dreyer and Kimberly Whelan and Jane Sande and Roger Berkow and Jackie Casallis and Lonnie Zeltzer and Robert Goldsby and Arthur Ablin and Raymond Hutchinson and Joseph Neglia and Dennis Deapen and Norman Breslow and Dan Bowers and Gail Tomlinson and Buchanan, {George R.} and Louise Strong and Marilyn Stovall",
year = "2008",
month = "5",
day = "1",
doi = "10.1002/cncr.23405",
language = "English (US)",
volume = "112",
pages = "2071--2079",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "9",

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TY - JOUR

T1 - Twenty years of follow-up among survivors of childhood and young adult acute myeloid leukemia

T2 - A report from the Childhood Cancer Survivor Study

AU - Mulrooney, Daniel A.

AU - Dover, Douglas C.

AU - Li, Suwen

AU - Yasui, Yutaka

AU - Ness, Kirsten K.

AU - Mertens, Ann C.

AU - Neglia, Joseph P.

AU - Sklar, Charles A.

AU - Robison, Leslie L.

AU - Davies, Stella M.

AU - Hudson, Melissa

AU - Armstrong, Greg

AU - Perkins, Joanna

AU - O'Leary, Maura

AU - Friedman, Debra

AU - Pendergrass, Thomas

AU - Greffe, Brian

AU - Odom, Lorrie

AU - Ruccione, Kathy

AU - Mulvihill, John

AU - Ginsberg, Jill

AU - Meadows, Anna

AU - Tersak, Jean

AU - Ritchey, A. Kim

AU - Blatt, Julie

AU - Reaman, Gregory

AU - Packer, Roger

AU - Davies, Stella

AU - Bhatia, Smita

AU - Qualman, Stephen

AU - Hammond, Sue

AU - Termuhlen, Amanda

AU - Ruymann, Frederick

AU - Diller, Lisa

AU - Grier, Holcombe

AU - Li, Frederick

AU - Meacham, Lillian

AU - Mertens, Ann

AU - Leisenring, Wendy

AU - Potter, John

AU - Greenberg, Mark

AU - Nathan, Paul C.

AU - Boice, John

AU - Rodriguez, Vilmarie

AU - Smithson, W. Anthony

AU - Gilchrist, Gerald

AU - Sklar, Charles

AU - Oeffinger, Kevin

AU - Finklestein, Jerry

AU - Anderson, Barry

AU - Inskip, Peter

AU - Vik, Terry A.

AU - Weetman, Robert

AU - Green, Daniel M.

AU - Hayashi, Robert

AU - Vietti, Teresa

AU - Marina, Neyssa

AU - Donaldson, Sarah S.

AU - Link, Michael P.

AU - Dreyer, Zoann

AU - Whelan, Kimberly

AU - Sande, Jane

AU - Berkow, Roger

AU - Casallis, Jackie

AU - Zeltzer, Lonnie

AU - Goldsby, Robert

AU - Ablin, Arthur

AU - Hutchinson, Raymond

AU - Neglia, Joseph

AU - Deapen, Dennis

AU - Breslow, Norman

AU - Bowers, Dan

AU - Tomlinson, Gail

AU - Buchanan, George R.

AU - Strong, Louise

AU - Stovall, Marilyn

PY - 2008/5/1

Y1 - 2008/5/1

N2 - BACKGROUND. Limited data exist on the comprehensive assessment of late medical and social effects experienced by survivors of childhood and young adult acute myeloid leukemia (AML). METHODS. This analysis included 272 5-year AML survivors who participated in the Childhood Cancer Survivor Study (CCSS). All patients were diagnosed at age ≤21 years between the years 1970 and 1986, and none underwent stem cell transplantation. Rates of survival, relapse, and late outcomes were analyzed. RESULTS. The average follow-up was 20.5 years (range, 5-33 years). The overall survival rate was 97% at 10 years (95% confidence interval [95%CI], 94%-98%) and 94% at 20 years (95% CI, 90%-96%). Six survivors reported 8 recurrences. The cumulative incidence of recurrent AML was 6.6% at 10 years (95% CI, 3.7%-9.6%) and 8.6% at 20 years (95% CI, 5.1%-12.1%). Ten subsequent malignant neoplasms (SMN) were reported, including 4 with a history of radiation therapy, for a 20-year cumulative incidence of 1.7% (95% CI, 0.02%-3.4%). Six cardiac events were reported, for a 20-year cumulative incidence 4.7% (95% CI, 2.1%-7.3%). Half of the survivors reported a chronic medical condition and, compared with siblings, were at increased risk for severe or life-threatening chronic medical conditions (16% vs 5.8%; P < .001). Among those aged ≥25 years, the age-adjusted marriage rates were similar among survivors and the general United States population (57% for both) and lower compared with siblings (67%; P < .01). Survivors' college graduation rates were lower compared with siblings but higher than the general population (40% vs 52% vs 34%, respectively; P < .01). Employment rates were similar between survivors, siblings, and the general population (93%, 97.6%, and 95.8%, respectively). CONCLUSIONS. Long-term survival from childhood AML ≥5-years after diagnosis was favorable. Late-occurring medical events remained a concern with socioeconomic achievement lower than expected within the individual family unit, although it was not different from the general United States population.

AB - BACKGROUND. Limited data exist on the comprehensive assessment of late medical and social effects experienced by survivors of childhood and young adult acute myeloid leukemia (AML). METHODS. This analysis included 272 5-year AML survivors who participated in the Childhood Cancer Survivor Study (CCSS). All patients were diagnosed at age ≤21 years between the years 1970 and 1986, and none underwent stem cell transplantation. Rates of survival, relapse, and late outcomes were analyzed. RESULTS. The average follow-up was 20.5 years (range, 5-33 years). The overall survival rate was 97% at 10 years (95% confidence interval [95%CI], 94%-98%) and 94% at 20 years (95% CI, 90%-96%). Six survivors reported 8 recurrences. The cumulative incidence of recurrent AML was 6.6% at 10 years (95% CI, 3.7%-9.6%) and 8.6% at 20 years (95% CI, 5.1%-12.1%). Ten subsequent malignant neoplasms (SMN) were reported, including 4 with a history of radiation therapy, for a 20-year cumulative incidence of 1.7% (95% CI, 0.02%-3.4%). Six cardiac events were reported, for a 20-year cumulative incidence 4.7% (95% CI, 2.1%-7.3%). Half of the survivors reported a chronic medical condition and, compared with siblings, were at increased risk for severe or life-threatening chronic medical conditions (16% vs 5.8%; P < .001). Among those aged ≥25 years, the age-adjusted marriage rates were similar among survivors and the general United States population (57% for both) and lower compared with siblings (67%; P < .01). Survivors' college graduation rates were lower compared with siblings but higher than the general population (40% vs 52% vs 34%, respectively; P < .01). Employment rates were similar between survivors, siblings, and the general population (93%, 97.6%, and 95.8%, respectively). CONCLUSIONS. Long-term survival from childhood AML ≥5-years after diagnosis was favorable. Late-occurring medical events remained a concern with socioeconomic achievement lower than expected within the individual family unit, although it was not different from the general United States population.

KW - Acute myeloid leukemia

KW - Medical late effects

KW - Social late effects

KW - Survivorship

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JF - Cancer

SN - 0008-543X

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