2025-02-28
After leukemia, a lifelong follow-up!
Oncology
#Leukemia #ALL #AML #LongTermFollowUp #Oncology #Cancer
Thanks to advances in pediatric oncology, the vast majority of children with acute leukemia are now cured. More than 90% of patients with acute lymphoblastic leukemia (ALL) and about 60 to 70% of children with acute myeloid leukemia (AML) survive thanks to progress in chemotherapy, immunotherapy, and stem cell transplantation.
However, these aggressive treatments lead to late side effects that can impact survivors’ quality of life. Around 20% of former ALL patients and the majority of AML survivors develop a chronic illness within 20 to 25 years of diagnosis. These complications often affect the heart, metabolism, bones, or nervous system, increasing the risk of premature mortality.
Although these side effects are well-documented, they are sometimes underestimated. It is therefore crucial to ensure regular, personalized medical follow-up to detect and manage these complications early.
This study explores the long-term impact of childhood leukemia treatments and the importance of structured follow-up to improve survivor care.
This study is based on cohort analyses of pediatric leukemia survivors to identify late adverse effects of treatments. The studied complications include:
Leukemia survivors are at high risk of chronic complications. On average, a patient treated for ALL develops between 4 and 16 chronic conditions over the 50 years following recovery, while those who had AML develop between 7 and 19.
Cardiovascular and endocrine diseases are among the most common complications, requiring long-term follow-up. Additionally, many survivors experience neurocognitive disorders, particularly after radiotherapy or certain chemotherapies, affecting memory, concentration, and learning. These findings highlight the importance of tailored care and structured medical follow-up to minimize long-term sequelae.
Thanks to advances in pediatric oncology, ALL and AML have become largely curable. However, the intensive treatments required for recovery expose survivors to late side effects, sometimes debilitating, which can affect their long-term quality of life.
This study aims to analyze the impact of pediatric leukemia treatments on long-term health and to highlight the importance of appropriate medical follow-up to prevent and manage late side effects.
Early identification of late complications is crucial to ensuring a better quality of life for survivors. A structured follow-up, based on international guidelines such as the Survivor Passport, allows long-term care to be tailored, complications to be better anticipated, and patient management to be improved.
Despite advances in understanding late side effects, major challenges remain. Access to medical follow-up for leukemia survivors remains unequal, and the long-term effects of newer treatments, such as targeted therapies and immunotherapies, are still poorly understood. The future of follow-up care lies in personalized approaches, combining tailored surveillance, early management of complications, and preventive strategies. Improving access to post-cancer care and developing less toxic treatments will be essential to ensuring a better quality of life for recovered patients.
Thanks to advances in pediatric oncology, the vast majority of children with acute leukemia are now cured. More than 90% of patients with acute lymphoblastic leukemia (ALL) and about 60 to 70% of children with acute myeloid leukemia (AML) survive thanks to progress in chemotherapy, immunotherapy, and stem cell transplantation.
However, these aggressive treatments lead to late side effects that can impact survivors’ quality of life. Around 20% of former ALL patients and the majority of AML survivors develop a chronic illness within 20 to 25 years of diagnosis. These complications often affect the heart, metabolism, bones, or nervous system, increasing the risk of premature mortality.
Although these side effects are well-documented, they are sometimes underestimated. It is therefore crucial to ensure regular, personalized medical follow-up to detect and manage these complications early.
This study explores the long-term impact of childhood leukemia treatments and the importance of structured follow-up to improve survivor care.
Read next: ALL: a constantly evolving battle
Cure—at what cost?
This study is based on cohort analyses of pediatric leukemia survivors to identify late adverse effects of treatments. The studied complications include:
- Metabolic toxicity: metabolic syndrome, obesity, diabetes.
- Gonadotoxicity and infertility: fertility disorders caused by chemotherapy and radiotherapy.
- Endocrine disorders: impaired growth hormones and thyroid dysfunctions.
- Bone damage: osteoporosis, osteonecrosis due to corticosteroids.
- Neurotoxicity: damage to the central and peripheral nervous systems affecting cognitive and motor functions.
- Cardiotoxicity: heart failure, hypertension linked to anthracyclines.
- Psychosocial consequences: anxiety, depression, social integration difficulties.
- Premature aging: acceleration of cellular degeneration processes, increased late mortality.
Leukemia survivors are at high risk of chronic complications. On average, a patient treated for ALL develops between 4 and 16 chronic conditions over the 50 years following recovery, while those who had AML develop between 7 and 19.
Cardiovascular and endocrine diseases are among the most common complications, requiring long-term follow-up. Additionally, many survivors experience neurocognitive disorders, particularly after radiotherapy or certain chemotherapies, affecting memory, concentration, and learning. These findings highlight the importance of tailored care and structured medical follow-up to minimize long-term sequelae.
Read next: Sepsis and memory: a link not to be forgotten!
Surviving, but Under Surveillance!
Thanks to advances in pediatric oncology, ALL and AML have become largely curable. However, the intensive treatments required for recovery expose survivors to late side effects, sometimes debilitating, which can affect their long-term quality of life.
This study aims to analyze the impact of pediatric leukemia treatments on long-term health and to highlight the importance of appropriate medical follow-up to prevent and manage late side effects.
Early identification of late complications is crucial to ensuring a better quality of life for survivors. A structured follow-up, based on international guidelines such as the Survivor Passport, allows long-term care to be tailored, complications to be better anticipated, and patient management to be improved.
Despite advances in understanding late side effects, major challenges remain. Access to medical follow-up for leukemia survivors remains unequal, and the long-term effects of newer treatments, such as targeted therapies and immunotherapies, are still poorly understood. The future of follow-up care lies in personalized approaches, combining tailored surveillance, early management of complications, and preventive strategies. Improving access to post-cancer care and developing less toxic treatments will be essential to ensuring a better quality of life for recovered patients.
Read next: IVIG: an ally against fever in ALL?
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