title: Late effects of childhood acute leukemia and its treatment.
abstract: Late effects of childhood acute leukemia and its treatment were studied in 776 patients (684 ALL, 73 ANLL, and 9 others) in Japan who had remained in remission for more than 1 year after their first complete remission. Delayed adverse sequelae involve a wide variety of organs and their functions. Short stature was present in 2.61%, obesity in 3.79%, abnormalities of growth hormone secretion in 1.5%, delayed secondary sex characteristics in 1.5% of males and 0.6% of females, motor disturbances in 1.17%, sensory disturbances in 0.91%, intellectual and learning disabilities in 2.48%, abnormal findings in routine neurologic examinations in 1.31%, EEG abnormalities in 4.30%, brain CT abnormalities in 5.09% and cardiac dysfunction in 1.07%. Various other disorders were seen in 20 patients. Many of these delayed adverse sequelae are caused by or related to central nervous system prophylaxis and systemic combination chemotherapy. The results suggest that it is needed to improve therapeutic methods through the stratification of patients by risk factors and detailed analysis of prognostic factors. Moreover it is important to render medical and psychosocial support to long-term survivors of childhood leukemia through interactions between the patient, parents and medical staff.
authors.affiliation: Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Fukunaga
authors.forename: I
authors.initials: I
authors.lastname: Tsukimoto
authors.forename: F
authors.initials: F
authors.lastname: Bessho
authors.forename: J
authors.initials: J
authors.lastname: Akatsuka
authors.forename: R
authors.initials: R
authors.lastname: Hosoya
authors.forename: S
authors.initials: S
authors.lastname: Nakazawa
authors.forename: M
authors.initials: M
authors.lastname: Sakurai
authors.forename: K
authors.initials: K
authors.lastname: Ueda
authors.forename: S
authors.initials: S
authors.lastname: Miyazaki
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001927:Brain Diseases / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000209:etiology*; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000150:complications / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000628:therapy; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000628:therapy; D011832:Radiation Injuries / Q000150:complications*; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents