Impact of Risk-Stratified Therapy on Health Status in Survivors of Childhood Acute Lymphoblastic Leukemia: A Report from the Childhood Cancer Survivor Study
| Autor: | Ching-Hon Pui, Gregory T. Armstrong, Leslie L. Robison, Stephen P. Hunger, Lewis B. Silverman, Daniel M. Green, Melissa M. Hudson, Ann C. Mertens, Kevin C. Oeffinger, Wendy M. Leisenring, Joseph P. Neglia, Paul C. Nathan, Kevin R. Krull, Kirsten K. Ness, Yutaka Yasui, Nina S. Kadan-Lottick, Rebecca M. Howell, Stephanie B. Dixon, Yan Chen |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Epidemiology Health Status MEDLINE Childhood Cancer Survivor Study Risk Assessment Article Cancer Survivors Proxy report Prevalence medicine Humans Sibling Child Childhood all Childhood Acute Lymphoblastic Leukemia business.industry Precursor Cell Lymphoblastic Leukemia-Lymphoma Confidence interval Oncology Female General health business |
| Zdroj: | Cancer Epidemiol Biomarkers Prev |
| ISSN: | 1538-7755 1055-9965 |
| DOI: | 10.1158/1055-9965.epi-21-0667 |
| Popis: | Background: Prior studies have identified that survivors of childhood acute lymphoblastic leukemia (ALL) report poor health status. It is unknown how risk-stratified therapy impacts the health status of ALL survivors. Methods: We estimated and compared the prevalence of self-reported poor health status among adult (≥18 years) survivors of childhood ALL diagnosed at age Results: Among 5,119 survivors and 4,693 siblings, survivors were more likely to report poor health status in each domain including poor general health (13.5% vs. 7.4%; PR = 1.92; 95% CI, 1.69–2.19). Compared with 70s, 90sSR and 90sHR were less likely to report poor general health (90sSR: PR = 0.75; 95% CI, 0.57–0.98; 90sHR: PR = 0.58; 95% CI, 0.39–0.87), functional impairment (90sSR: PR = 0.56; 95% CI, 0.42–0.76; 90sHR: PR = 0.63; 95% CI, 0.42–0.95), and activity limitations (90sSR: 0.61; 95% CI, 0.45–0.83; 90sHR: PR = 0.59; 95% CI, 0.38–0.91). An added adjustment for chronic conditions in multivariable models partially attenuated 90sSR risk estimates. Conclusions: Risk-stratified ALL therapy has succeeded in reducing risk for poor general health, functional impairment, and activity limitations among more recent survivors of standard- and high-risk therapy. Impact: Future research into the relationship between risk-stratified therapy, health status, and late health outcomes may provide new opportunities to further improve late morbidity among survivors. |
| Databáze: | OpenAIRE |
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