title: Quality of health in survivors of childhood acute myeloid leukemia treated with chemotherapy only: a NOPHO-AML study.
abstract: BACKGROUND
  More than 60% of children with acute myeloid leukemia (AML) become long-term survivors, and approximately 50% are cured with chemotherapy only. Limited data exist about their long-term morbidity and social outcomes. The aim of the study was to compare the self-reported use of health care services, health experience, social outcomes, and lifestyle behavior of AML survivors with that of their sibling controls.
  
  
  METHODS
  This population-based study included 138 children treated for AML according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO)-AML-84, -88, and -93 trials, and alive by June 30, 2007. Patients treated with hematopoietic stem cell transplantation (HSCT) or relapse were not included. Altogether, 102 (74%) survivors and 91% of their siblings completed a questionnaire.
  
  
  RESULTS
  The median follow-up was 11 (range 4-25) years after diagnosis. AML survivors had no increased rate of hospitalization compared with sibling controls, but were more often receiving prescription drugs, especially for asthma (23% vs. 9%, P = 0.03). Self-reported health experience was excellent or very good in 77% and comparable with that of siblings. Educational achievement, employment, and marital status were comparable in the two groups. Among surviving AML patients, 23% were current smokers and 24% of their siblings were current smokers.
  
  
  CONCLUSIONS
  The self-reported health of children treated on NOPHO-AML protocols without HSCT was good, and their use of health care services was limited. Reported health and social outcomes were comparable to those of their siblings. Many survivors were smoking which may increase the risk of late effects.
authors.affiliation: Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark. lene.molgaard@dadlnet.dk
authors.forename: Lene
authors.initials: L
authors.lastname: Molgaard-Hansen
authors.forename: Heidi
authors.initials: H
authors.lastname: Glosli
authors.forename: Kirsi
authors.initials: K
authors.lastname: Jahnukainen
authors.forename: Marianne
authors.initials: M
authors.lastname: Jarfelt
authors.forename: Guðmundur K
authors.initials: GK
authors.lastname: Jónmundsson
authors.forename: Johan
authors.initials: J
authors.lastname: Malmros-Svennilson
authors.forename: Karsten
authors.initials: K
authors.lastname: Nysom
authors.forename: Henrik
authors.initials: H
authors.lastname: Hasle
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult