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Long-term sequelae in survivors of childhood leukemia with Down syndrome: A childhood cancer survivor study report
- Source :
- Cancer, vol 124, iss 3
- Publication Year :
- 2018
- Publisher :
- eScholarship, University of California, 2018.
-
Abstract
- BackgroundChildren with Down syndrome (DS) are at increased risk of developing acute leukemia and are more prone to acute toxicities. We studied the incidence and severity of chronic health conditions among survivors of childhood leukemia with DS compared with those without DS.MethodsChronic health conditions reported by questionnaire were compared between 154 pediatric leukemia survivors with DS and 581 without DS, matched by leukemia, age at diagnosis, race/ethnicity, sex, radiation location and chemotherapy exposure using Cox models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Subjects were selected from 7139 5-year survivors of leukemia in the Childhood Cancer Survivor Study.ResultsRisk of at least 1 late onset chronic health condition (grade 1-5) was similar in the DS population compared with the non-DS group (HR, 1.1; 95% CI, 0.7-1.5). Serious chronic health conditions (grade 3-5) were more common in DS survivors (HR, 1.7; 95% CI, 1.1-2.6), as were ≥ 3 chronic health conditions (grades 1-5) (HR, 1.7; 95% CI, 1.2-2.4). The 25-year cumulative incidence of any condition (grades 1-5) was 83% for DS survivors and 69% for non-DS survivors.ConclusionLeukemia survivors with DS have therapy-related chronic health conditions comparable to those of similarly treated survivors without DS, with a few notable exceptions: 1) an increased risk of cataracts, hearing loss, and thyroid dysfunction compared with survivors without DS (though these are known risks in the DS population), 2) decreased risk of second cancers, and 3) increased risk of severe or multiple conditions. Practitioners should be aware of these risks during and after therapy. Cancer 2018;124:617-25. © 2017 American Cancer Society.
- Subjects :
- Adult
Male
Pediatric Research Initiative
Adolescent
Childhood Leukemia
Pediatric Cancer
Down syndrome
Intellectual and Developmental Disabilities (IDD)
Oncology and Carcinogenesis
Young Adult
Rare Diseases
Cancer Survivors
Clinical Research
Neoplasms
Humans
late effects
2.1 Biological and endogenous factors
Oncology & Carcinogenesis
Aetiology
Child
Proportional Hazards Models
Cancer
Pediatric
Leukemia
Prevention
Rehabilitation
leukemia
Hematology
Middle Aged
chronic conditions
Brain Disorders
Second Primary
Chronic Disease
Public Health and Health Services
Female
Down Syndrome
survivorship
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Cancer, vol 124, iss 3
- Accession number :
- edsair.od.......325..3f4861799301212e13e07c57df9fca9c