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. 2021 Aug;35(8):2258-2273.
doi: 10.1038/s41375-021-01134-3. Epub 2021 Jan 25.

Late outcomes in survivors of childhood acute myeloid leukemia: a report from the St. Jude Lifetime Cohort Study

Neel S Bhatt #  1   2 , Malek J Baassiri #  3 , Wei Liu  4 , Nickhill Bhakta  5   6 , Wassim Chemaitilly  5   7 , Matthew J Ehrhardt  5   8 , Hiroto Inaba  8 , Kevin Krull  5   9 , Kirsten K Ness  5 , Jeffrey E Rubnitz  8 , Deokumar Srivastava  4 , Leslie L Robison  5 , Melissa M Hudson  5   8   10 , Daniel A Mulrooney  11   12   13
Affiliations

Late outcomes in survivors of childhood acute myeloid leukemia: a report from the St. Jude Lifetime Cohort Study

Neel S Bhatt et al. Leukemia. 2021 Aug.

Abstract

Cumulative burden of chronic health conditions and neurocognitive and physical function were examined among survivors of childhood acute myeloid leukemia (AML) treated with hematopoietic cell transplant (HCT; n = 66) or conventional therapy (CT; n = 67). Survivors and controls underwent a comprehensive clinical assessment, and health conditions were graded using a modified version of the Common Terminology Criteria for Adverse Events. By age 40 years, HCT and CT survivors had an average 17.4 (95% confidence interval [CI] 14.6-20.1) and 9.3 (7.7-11.1) grade 1-4 conditions versus 3.8 (3.3-4.2) in community controls. Compared to controls, HCT survivors had a higher prevalence of hypertriglyceridemia (45.5% vs. 18.3%), hypercholesterolemia (47.0% vs. 30.9%), hypothyroidism (27.3% vs. 4.0%), and primary hypogonadism (p < 0.001). CT survivors had a higher prevalence of cardiomyopathy (11.9% vs. 2.7%) and hypertension (53.7% vs. 44.3%). Neurocognitive impairment was elevated across all domains compared to controls but did not differ by treatment modality. Compared to controls, a higher proportion of HCT survivors had impairments in strength and endurance; whereas flexibility and mobility impairments were noted among CT survivors. Despite successful advances in childhood AML therapy, many therapeutic exposures remain unchanged. These findings support ongoing investigations of novel therapies and strategies to ameliorate the risk of late morbidities.

Trial registration: ClinicalTrials.gov NCT00760656.

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Conflict of interest statement

Competing Interests:

The authors declare no competing financial interest

Figures

Figure 1.
Figure 1.
Cumulative burden and 95% confidence intervals of grade 1–4 and 2–4 overall chronic health conditions among survivors of AML treated with allogeneic hematopoietic cell transplant (HCT) or conventional therapy (non-HCT) and community controls
Figure 2:
Figure 2:
Neurocognitive impairment among HCT survivors and controls by domains (A. Executive function, B. Processing speed, C. Memory, D. Attention)
Figure 3:
Figure 3:
Neurocognitive impairment among CT survivors and controls by domains (A. Executive function, B. Processing speed, C. Memory, D. Attention)
Figure 4:
Figure 4:
A:Prevalence of physical function impairments among survivors of AML treated with HCT B:Prevalence of physical function impairments among survivors of AML treated with CT
See this image and copyright information in PMC

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