[Long-term care of young adults surviving childhood cancer - where do we go?]

Abstract

Methods: Between January 1990 and November 2006, 65 consecutive childhood cancer survivors entered a prospective follow-up study to evaluate the frequency and severity of tumor- and/or therapy-related long-term sequelae. Their median age at diagnosis was 9.7 years, median actual age is 25.1 years, and median duration of follow-up is 14.8 years.

Results: Nine patients (13.9%) were completely free from late effects, whereas 31/65 patients (47.6%) had only minimal late effects without need of medical support and 25/65 patients (38.5%) had severe late effects requiring long-term medical care. The most frequent late effects were endocrine deficits, musculosceletal problems, neurologic problems, chronic hepatitis and hearing loss. Currently, a network of local adult care providers is being established in order to enable a smooth and competent referral from pediatric hemato-oncology to adult medicine.

Conclusions: Two thirds of former childhood cancer patients are able to return to everyday life without any impairment. However, one third is suffering from considerable morbidity requiring long-term medical care. Transition models from pediatric hemato-oncology to adult health care providers are urgently needed.