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Blood, 15 June 2008, Vol. 111, No. 12, pp. 5515-5523. Prepublished online as a Blood First Edition Paper on March 11, 2008; DOI 10.1182/blood-2007-10-117150. This Article Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2007-10-117150v1 111/12/5515    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Mody, R. Articles by Neglia, J. P Search for Related Content PubMed PubMed Citation Articles by Mody, R. Articles by Neglia, J. P Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted October 9, 2007 Accepted February 25, 2008 Twenty five year follow-up among survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study Rajen Mody, Suwen Li, Douglas C Dover, Stephen Sallan, Wendy Leisenring, Kevin C Oeffinger, Yutaka Yasui, Leslie L Robison, and Joseph P Neglia* Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States School of Public Health, University of Alberta, Edmonton, AB, Canada Department of Biostatistics, The Fred Hutchinson Cancer Research Center, Seattle, WA, United States Department of Pediatrics, Dana Farber Cancer Institute, Boston, MA, United States Departments of Pediatrics and Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, United States Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States * Corresponding author; email: jneglia{at}umn.edu. Survivors of childhood ALL are at risk for late effects of cancer therapy. A cohort of 5-year ALL survivors (<21 years at diagnosis) (n=5760 eligible, 4151 participants), diagnosed between 1970-1986 was compared to the general population and a sibling cohort (n=3899). Cumulative mortality of 5760 5-year survivors was 13% at 25 years from diagnosis. Recurrent ALL (n=483) and second neoplasms (SN)(n= 89) were the major causes of death. A total of 199 SN occurred among 185 survivors; 53% in the CNS. Survivors reported more multiple Chronic Medical Conditions (CMC) OR, 2.8; (95% CI, 2.4-3.2) and severe or life threatening CMC OR, 3.6 (95% CI, 3.0-4.5) than siblings. The cumulative incidence of severe CMC including death, 25 years from diagnosis was 21.3% (95% CI, 18.2-24.4) [23.3% (95% CI, 19.4-27.2) and 13.4% (95% CI, 8.4-18.4) for irradiated and non-irradiated survivors, respectively]. Survivors reported higher adverse general and mental health, functional impairment and activity limitations compared to siblings (P <0.0001). Rates of marriage, college graduation, employment and health insurance were all lower compared to sibling controls (P< 0.001). Long-term survivors of childhood ALL exhibit excess mortality and morbidity from therapy received in the 1970s and early to mid 1980s. Survivors who received radiation therapy as part of their treatment or had a leukemia relapse are at greatest risk for adverse outcomes. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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