Late Effects of Therapy of Acute Lymphoblastic Leukemia

2022 ◽  
pp. 267-291
Author(s):  
Liv Andrés-Jensen ◽  
Christoffer Johansen ◽  
Kjeld Schmiegelow
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Late Effects ◽  
Lymphoblastic Leukemia

scholarly journals Executive function late effects in survivors of pediatric brain tumors and acute lymphoblastic leukemia

2014 ◽  
Vol 36 (8) ◽  
pp. 818-830 ◽  
Author(s):  
Amanda L. Winter ◽  
Heather M. Conklin ◽  
Vida L. Tyc ◽  
Heather Stancel ◽  
Pamela S. Hinds ◽  
...  
Keyword(s):  
Executive Function ◽  
Acute Lymphoblastic Leukemia ◽  
Brain Tumors ◽  
Late Effects ◽  
Lymphoblastic Leukemia ◽  
Pediatric Brain Tumors ◽  
Pediatric Brain

scholarly journals Alteration in Bone Mineral Metabolism in Children with Acute Lymphoblastic Leukemia (ALL): A Review

2009 ◽  
Vol 1 (1) ◽  
pp. 29
Author(s):  
Chowdhury Yakub Jamal
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Bone Mineral ◽  
Late Effects ◽  
Mineral Metabolism ◽  
Lymphoblastic Leukemia ◽  
Prostaglandin E ◽  
Mineral Density ◽  
Metabolic Alterations ◽  
Bone Mineral Metabolism ◽  
Pediatric Cancer Patients

<p>In recent years there has been a significant increase in event free survival (EFS) and overall survival in children with cancer. As survival rates for childhood cancer have radically improved, late effects associated with the successful but highly intensive chemotherapy and/or radiotherapy have dramatically increased. Many possible late effects of cancer treatment are recognized in pediatric cancer patients as infertility, endocrine deficiency, renal failure, pulmonary and cardiac toxicity, obesity and osteopenia/osteoporosis. Decreased bone mineral density (BMD) and bone metabolism disturbances have been recognized and reported in literature. Osteopenia/osteoporosis skeletal abnormalities, osteonecrosis and pathological fractures are known to occur frequently in childhood acute lymphoblastic leukemia (ALL) at diagnosis, during and after treatment with chemotherapy. Various studies have revealed different metabolic alterations related to ALL. Some suggestions have been made about their relationship with the disease process. Various metabolic abnormalities may be encountered in the newly diagnosed ALL patients. It includes decreased and increased serum levels of calcium and phosphate. Hypercalcemia may result from leukemic infiltrations of bone and release of parathormone like substance from lymphoblast. Elevated serum phosphate can occur as a result of leukemic cell lysis and may induce hypocalcemia. It has been postulated by other authors that leukemic cells may directly infiltrate bone and produce parathroid hormone related peptides, prostaglandin E and osteoblast inhibiting factors. Hypomagnesemia, hypocalcaemia and hypothyroidisum have been demonstrated in patients with ALL. Some patients may have poor nutrition and decreased physical activities during treatment. However postulations have also been made that chemotherapy may play a role in creating metabolic alterations in children with ALL. Corticosteroid, methotraxate and cranial irradiations have all been assumed as a cause of loss of bone mass. Continuing chemotherapy in children with ALL was assumed with normal growth and normal or high collagen turnover and reduced alkaline phosphatase or impaired osteoblastic activity on mineralization of bone. Considering the derangements in bone mineral metabolism in ALL at diagnosis or with chemotherapy, it is imperative that specific attention and therapeutic measures should be considered.</p><p>DOI: 10.3329/bsmmuj.v1i1.3695</p> <p><em>BSMMU J </em>2008; 1(1): 29-32</p>

scholarly journals Late Effects in Survivors of Adolescent and Young Adult Acute Lymphoblastic Leukemia

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Lori Muffly ◽  
Frances B Maguire ◽  
Qian Li ◽  
Vanessa Kennedy ◽  
Theresa H Keegan
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Young Adult ◽  
Late Effects ◽  
Hematopoietic Cell Transplantation ◽  
Lymphoblastic Leukemia ◽  
Large Population ◽  
Population Based ◽  
Adolescent And Young Adult ◽  
Second Neoplasms ◽  
Multivariable Analyses

Abstract Background Knowledge regarding late effects (medical conditions and subsequent neoplasms) in survivors of adolescent and young adult (AYA) acute lymphoblastic leukemia (ALL) is lacking. Methods Using the population-based California Cancer Registry linked with California hospitalization data, we evaluated late effects in 1069 AYAs (aged 15–39 years) diagnosed with ALL in California between 1995 and 2012 and surviving a minimum of 3 years from diagnosis. Results The estimated 10-year cumulative incidence of subsequent endocrine disease (28.7%, 95% confidence interval [CI] = 25.8% to 31.6%) and cardiac disease (17.0%, 95% CI = 14.6% to 19.5%) were strikingly high; avascular necrosis (9.6%, 95% CI = 7.8% to 11.6%), liver disease (6.5%, 95% CI = 5.0% to 8.3%), respiratory disease (6.2%, 95% CI = 4.8% to 8.0%), seizure and/or stroke (4.3%, 95% CI = 3.1% to 5.8%), renal disease (3.1%, 95% CI = 2.1% to 4.4%), and second neoplasms (1.4%, 95% CI = 0.7% to 2.4%) were estimated to occur at 10 years with the reported frequencies. Multivariable analyses including the entire patient cohort demonstrated that public or no insurance (vs private and/or military insurance) and receipt of hematopoietic cell transplantation were independently associated with the occurrence of all late effects considered. In multivariable analyses limited to the 766 AYAs who were not transplanted, we continued to find a statistically significant association between public and no insurance and the occurrence of all late effects. Frontline regimen type (pediatric vs adult) was not statistically significantly associated with any of the late effect categories. Conclusions This large population-based analysis is among the first to describe late effects in survivors of AYA ALL. The strong association between insurance type and late effects suggests that AYAs with public or no insurance may have reduced access to survivorship care following completion of ALL therapy.

Late effects in survivors of childhood acute lymphoblastic leukemia: a study from Thai Pediatric Oncology Group

2010 ◽  
Vol 91 (5) ◽  
pp. 850-854 ◽  
Author(s):  
Samart Pakakasama ◽  
Gavivann Veerakul ◽  
Darin Sosothikul ◽  
Su-on Chainansamit ◽  
Vichai Laosombat ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Pediatric Oncology ◽  
Late Effects ◽  
Lymphoblastic Leukemia ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Oncology Group ◽  
Pediatric Oncology Group

scholarly journals Balancing cure and long-term risks in acute lymphoblastic leukemia

Hematology ◽  
2014 ◽  
Vol 2014 (1) ◽  
pp. 190-197 ◽  
Author(s):  
Lewis B. Silverman
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Late Effects ◽  
Pediatric Patients ◽  
Lymphoblastic Leukemia ◽  
Malignant Neoplasms ◽  
Second Malignant Neoplasms ◽  
Current Therapies ◽  
Cure Rates ◽  
Long Term Survivors

Abstract Cure rates for children and adolescents with acute lymphoblastic leukemia (ALL) have improved dramatically over the last few decades. With this success has come increasing recognition of the adverse late effects of treatment. The significant long-term sequelae in the earliest cohort of long-term survivors treated in the 1970s and 1980s are well documented. To reduce the incidence of these late effects, the majority of pediatric patients treated on more contemporary regimens receive less intensive treatment than did those treated 30-40 years ago. However, current therapies are not risk free; children treated with contemporary regimens remain at risk for developing long-term toxicities, including cardiac dysfunction, osteonecrosis, neurocognitive impairment, and second malignant neoplasms. One of the great challenges facing clinical investigators today is to identify interventions that will reduce the frequency and severity of long-term toxicities without adversely affecting cure rates. The use of dexrazoxane as a cardioprotectant (to prevent anthracycline-associated cardiotoxicity) and alternate-week dosing of dexamethasone (to reduce the risk of osteonecrosis) are examples of 2 such successful strategies. This article provides an overview of the long-term toxicities associated with current therapies and reviews results of clinical trials designed to minimize the burden of cure in long-term survivors.

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