title: Adverse effects of treatment in childhood acute lymphoblastic leukemia: general overview and implications for long-term cardiac health.
abstract: Survival of childhood acute lymphoblastic leukemia (ALL) is one of the greatest medical success stories of the last four decades. Unfortunately, childhood ALL survivors experience medical late effects that increase their risk of morbidity and premature death, often due to heart and vascular disease. Research has helped elucidate the mechanisms and trajectory of direct damage to the heart from treatment exposure, particularly to anthracyclines, and has also contributed knowledge on the influences of related chronic conditions, such as obesity and insulin resistance on heart health in these survivors. This article summarizes the key issues associated with early morbidity and mortality from cardiac-related disease in childhood ALL survivors and suggests directions for interventions to improve long-term outcomes.
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Saro H
authors.initials: SH
authors.lastname: Armenian
authors.forename: Nina
authors.initials: N
authors.lastname: Kadan-Lottick
authors.forename: James G
authors.initials: JG
authors.lastname: Gurney
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D006331:Heart Diseases / Q000209:etiology; D019382:Human Growth Hormone / Q000172:deficiency / Q000378:metabolism; D006801:Humans; D008659:Metabolic Diseases / Q000150:complications; D009765:Obesity / Q000150:complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000401:mortality / Q000628:therapy*; D033581:Stem Cell Transplantation
chemical_list: D000903:Antibiotics, Antineoplastic; D019382:Human Growth Hormone