Health and risk behaviors in survivors of childhood acute myeloid leukemia: a report from the Children's Oncology Group.
BACKGROUND
Survivors of childhood acute myeloid leukemia (AML) face increased risks of chronic disease and secondary malignancies. Substance exposure may compound these risks.


METHODS
Participants were diagnosed with AML at <21 years of age and survived > or =5 years following diagnosis. All underwent chemotherapy alone or followed by autologous BMT (chemo +/- autoBMT) or underwent allogeneic BMT (alloBMT) if an HLA-matched related donor was available. Survivors completed a health questionnaire and a Youth Risk Behavior Survey (YRBS).


RESULTS
Of eligible survivors, 117 were > or =18 years of age and completed a YRBS. Survivors were a mean age of 10 years at diagnosis and 24 years at interview. Of the substance exposures assessed by YRBS, tobacco, alcohol, and marijuana were most common. Twenty-two percent (22%) had smoked cigarettes in the last 30 days. One-quarter (25%) reported binge drinking in the last month. None of these exposures varied by treatment group. Less than 10% of survivors reported cocaine, heroin, or methamphetamine use. Men were more likely to report high substance exposure (P = 0.004). Sadness/suicidality score was associated with cancer-related anxiety (P = 0.006) and multiple health conditions (P = 0.006).


CONCLUSIONS
This analysis reveals exposure to tobacco, alcohol, and marijuana in young adults with few differences based on treatment received. Survivors with cancer-related anxiety or multiple health conditions were more likely to report sadness/hopelessness.
Division of Hematology/Oncology, Children's Hospitals and Clinics of Minnesota, St. Paul, Minnesota 55102, USA. krisann.schultz@childrensmn.org
Kris Ann P
KA
Schultz
Lu
L
Chen
Zhengjia
Z
Chen
Lonnie K
LK
Zeltzer
H Stacy
HS
Nicholson
Joseph P
JP
Neglia
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017741:Survivors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D055815:Young Adult