Late Effects in Long-Term Survivors After Treatment for Childhood Acute Leukemia

Background. This is a report of late effects in childhood cancer survivors seen in the follow-up clinic of a single institution. Materials and methods. There were 324 acute leukemia survivors in the database of the Long Term Follow Up Clinic of Children's National Medical Center from January 1, 1997, through June 30, 2005. Results. Of the 324 acute leukemia survivors, 228 were white, 48 black, 20 Hispanic, and 12 other. Their follow-up time was 0 to 25 years (mean 5.3 years). One or more adverse events occurred in 74.1% of the 324 survivors. Defective physical growth was most commonly reported, followed by disturbed neurocognitive function, emotional difficulties, cardiac abnormalities, hypertension, osteoporosis/osteopenia, fractures, and second neoplasms. More black and Hispanic children had acute myeloid leukemia, relapses, cardiac problems, and hypertension than white and other subjects. Conclusion. Childhood cancer survivors require lifelong monitoring, with prompt identification and treatment of adverse late effects.