Quality of health in survivors of childhood acute myeloid leukemia treated with chemotherapy only: A NOPHO-AML study
| Autor: | Kirsi Jahnukainen, Guðmundur K Jónmundsson, Marianne Jarfelt, Henrik Hasle, Heidi Glosli, Lene Molgaard-Hansen, Johan Malmros-Svennilson, Karsten Nysom |
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| Rok vydání: | 2010 |
| Předmět: |
Chemotherapy
Pediatrics medicine.medical_specialty business.industry medicine.medical_treatment Organ dysfunction Childhood Acute Myeloid Leukemia Late effect Myeloid leukemia Hematology Childhood Cancer Survivor Study Oncology hemic and lymphatic diseases Pediatrics Perinatology and Child Health medicine Young adult medicine.symptom Age of onset business |
| Zdroj: | Pediatric Blood & Cancer. 57:1222-1229 |
| ISSN: | 1545-5009 |
| Popis: | Acute myeloid leukemia (AML) represents 20% of the acuteleukemiacasesinchildrenandadolescents.IntheNordiccountries,AML is diagnosed in approximately 30 children annually in a totalchildpopulationof4.5millionbelowtheageof15years.Thepasttwodecadeshaveseenamarkedimprovementinsurvival.TheresultsoftheNOPHO-AMLstudies(NordicSocietyofPediatricHematologyandOncology)areamongthebestintheworldwitha5-yearsurvivalrate of 65% [1,2]. The late morbidity and mortality after the veryintensive treatment therefore deserve attention.Long-termsurvivorsofchildhoodcancerareatriskofdevelopingseveraladverseoutcomesincludingearlydeath,secondneoplasms,organ dysfunction (e.g., cardiac and pulmonary), growth disturb-ance, reduced fertility, impaired intellectual function, difficultiesinobtainingemploymentandinsurance,andreducedqualityoflife[3–5]. Previous studies have reported common late effects afterchildhood AML [6–15]. In the Childhood Cancer Survivor Study(CCSS),62%ofAMLsurvivorsreportedachronicmedicalcondition[6]. However, most previous studies included rather few AMLsurvivors whose therapy varied considerably. Cranial irradiationhad been givento 9–100% of patients, and hematopoietic stem celltransplantation (HSCT) had been used in 0–60%. Many of the lateeffects reported in previous studies were probably caused by thesetreatments [7,9,10]. From 1984 to 2003, approximately 50% ofNordic children with AML were cured with chemotherapy only.Cranialirradiationwasnotused,andcumulativedosesofanthracy-clines were lower than in most other protocols [1,2]. However, thechemotherapyusedtocureAMLremainedveryintensiveanditsusewasassociatedwithmajoracutetoxicity,includingahighfrequencyof both early (6%) and late toxic death (7%) [2]. Limited data existabout the long-term mortality, morbidity, and social outcomes ofAML patients treated with chemotherapy only.The objective of the Nordic AML Late Effect Study was toinvestigatethespectrum,frequencyandpossibleriskfactorsforlateeffects of childhood AML cured by chemotherapy only. This studycomparedtheself-reporteduseofhealthcareservices,healthexperi-ence,socialoutcomes,andlifestylebehaviorofAMLsurvivorswiththose of their sibling controls. |
| Databáze: | OpenAIRE |
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