Late effects in survivors of infant leukemia
Open Access
- 1 July 2000
- journal article
- research article
- Published by Springer Science and Business Media LLC in Leukemia
- Vol. 14 (7), 1185-1190
- https://doi.org/10.1038/sj.leu.2401818
Abstract
Little is known about the incidence of and risk factor for late effects of infant leukemia. We evaluated 19 children with acute lymphoblastic leukemia and 15 with acute myeloid leukemia who were diagnosed at age 12 months or younger and have survived for more than 5 years after the diagnosis (median length of follow-up, 13 years; range, 5.7–29 years). Ten patients received chemotherapy alone (group A), 17 received chemotherapy and CNS-directed radiation therapy (CRT) (group B), and seven received chemotherapy, CRT and bone marrow transplantation (group C). The most frequently observed late sequelae included problems in growth (66% of survivors), learning (50%), hypothyroidism (15%), and pubertal development (12%). Cataract, cardiac and hearing abnormalities occurred in 6% of patients. Only eight patients (24%) survive without late effects. In comparison to patients in group A, patients in groups B and C had a higher incidence of having at least one late complication (P = 0.009), a greater decrease in height Z score at 5 years after diagnosis (P = 0.023), and a higher incidence of academic difficulties (P = 0.004). The estimated odds of academic difficulties increased by 18% (P = 0.032) for each month younger in age at the time of CRT. These results indicate that late sequelae are common in long-term survivors of infant leukemia and are often related to CRT and the patient's age at the time of CRT.Keywords
This publication has 24 references indexed in Scilit:
- Prognostic factors in infants with acute myeloid leukemiaLeukemia, 2000
- Prednisone Response Is the Strongest Predictor of Treatment Outcome in Infant Acute Lymphoblastic LeukemiaBlood, 1999
- Leukemia in InfantsThe Oncologist, 1999
- Treatment Outcome and Prognostic Factors for Infants With Acute Lymphoblastic Leukemia Treated on Two Consecutive Trials of the Children's Cancer GroupJournal of Clinical Oncology, 1999
- Early Intensification of Intrathecal Chemotherapy Virtually Eliminates Central Nervous System Relapse in Children With Acute Lymphoblastic LeukemiaBlood, 1998
- Conventional Compared with Individualized Chemotherapy for Childhood Acute Lymphoblastic LeukemiaThe New England Journal of Medicine, 1998
- Childhood LeukemiasThe New England Journal of Medicine, 1995
- 11q23/MLL rearrangement confers a poor prognosis in infants with acute lymphoblastic leukemia.Journal of Clinical Oncology, 1994
- Improved outcome in childhood acute lymphoblastic leukaemia with reinforced early treatment and rotational combination chemotherapyThe Lancet, 1991
- Childhood acute lymphocytic leukemia. Study VIIICancer, 1978