title: Late outcomes of adult survivors of childhood non-Hodgkin lymphoma: A report from the St. Jude Lifetime Cohort Study.
abstract: Survivors of childhood non-Hodgkin lymphoma (NHL) are at increased risk for chronic health conditions. The objective of this study was to characterize health conditions, neurocognitive function, and physical performance among a clinically evaluated cohort of 200 childhood NHL survivors.
  
  
  
  Chronic health and neurocognitive conditions were graded as per a modified version of the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) and impaired physical function defined as performance < 10th percentile of normative data. Multivariable regression was used to investigate associations between sociodemographic characteristics, therapeutic exposures, and outcomes.
  
  
  
  Survivors were a median age of 10 years (range 1-19) at diagnosis and 34 years (range 20-58) at evaluation. Eighty-eight (44%) received radiation, 46 (23%) cranial radiation, and 69 (35%) high-dose methotrexate. Most prevalent CTCAE Grades 3-4 (severe life-threatening) conditions were obesity (35%), hypertension (9%), and impairment of executive function (13%), attention (9%), and memory (4%). Many had impaired strength (48%), flexibility (39%), muscular endurance (36%), and mobility (36%). Demographic and treatment-related factors were associated with the development of individual chronic diseases and functional deficits.
  
  
  
  Clinical evaluation identified a high prevalence of chronic health conditions, neurocognitive deficits, and performance limitations in childhood NHL survivors.
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Ehrhardt
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: John T
authors.initials: JT
authors.lastname: Sandlund
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Health Sciences Research, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Nickhill
authors.initials: N
authors.lastname: Bhakta
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Wassim
authors.initials: W
authors.lastname: Chemaitilly
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Tara M
authors.initials: TM
authors.lastname: Brinkman
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Crom
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Larry
authors.initials: L
authors.lastname: Kun
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Sue C
authors.initials: SC
authors.lastname: Kaste
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Armstrong
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Green
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Kumar
authors.initials: K
authors.lastname: Srivastava
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Mulrooney
mesh_terms: D000293:Adolescent; D000328:Adult; D001288:Attention; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D007223:Infant; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008568:Memory; D019965:Neurocognitive Disorders / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D009765:Obesity / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D017741:Survivors
keywords: chronic health conditions; late effects; neurocognitive; non-Hodgkin lymphoma; survivorship