Pulmonary function after treatment for acute lymphoblastic leukaemia in childhood

Nysom, Karsten; Holm, Kirsten; Olsen, Jørgen H.; Hertz, H; Hesse, Birger

doi:10.1038/bjc.1998.436

Cited by 39 publications

(44 citation statements)

References 19 publications

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“…Pulmonary function can also be compromised by anticancer therapy, as reported in survivors of childhood leukemia (92,161,199), rhabdomyosarcoma (95), and Hodgkin disease (16,125,130), and in children treated with hematopoietic stem cell transplantation (23, 53). The lung is sensitive to both radiation and chemotherapy (1).…”

Section: Pulmonary Abnormalitiesmentioning

confidence: 99%

Adverse Late Effects of Childhood Cancer and Its Treatment on Health and Performance

Ness

Gurney

2007

Annu. Rev. Public Health

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More than 12,000 newly diagnosed cases of cancer occur each year in the United States among children ages 20 years or younger, and the current 5-year survival rate is near 80%. An estimated 228,000 among adults 47 years or younger and currently living in the United States had a diagnosis of cancer during childhood or adolescence. Here, we review long-term adverse effects of childhood cancer and its treatment with an emphasis on physical performance and health. We also briefly review existing guidelines that may be used to develop appropriate exercise and diet interventions for childhood cancer survivors. We suggest that there is a need for development of evidencebased, risk-based guidelines and interventions for health promotion among long-term childhood cancer survivors, particularly for those whose physical activity limitations interfere with chances for optimizing their bodies' potential in today's society.

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Section: Pulmonary Abnormalitiesmentioning

confidence: 99%

Adverse Late Effects of Childhood Cancer and Its Treatment on Health and Performance

Ness

Gurney

2007

Annu. Rev. Public Health

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“…Restrictive lung disease was mild in most patients and more common in those patients, who had RT to the lung, chest or mediastinum or central nervous system (CNS). Authors of other studies of lung function in survivors of childhood cancer reported different proportions of lung dam-age depending on the type of treatment (3,4,7,8,9,13). In long-term childhood cancer survivors, restrictive type of respiratory function defect is mostly found (in 10% to 87% of pts) (6,9,14,15,19,24,25).…”

Section: Discussionmentioning

confidence: 99%

“…In long-term childhood cancer survivors, restrictive type of respiratory function defect is mostly found (in 10% to 87% of pts) (6,9,14,15,19,24,25). Impairment of diffusing capacity is reported in high proportion as well (6)(7)(8). In the population of childhood cancer survivors, obstructive type of pulmonary dysfunction is rarely reported.…”

Section: Discussionmentioning

confidence: 99%

“…Chemotherapeutic agents such as cyclophosphamide, doxorubicin, bleomycin, methotrexate, carmustine, busulphan, paclitaxel, cisplatin have been linked to late pulmonary sequelae (1,4,(6)(7)(8)(9)(10)(11)(12) in form of restrictive lung disease and defects in diffusing capacity. Clinically, from 10% to 98% of these subjects are asymptomatic (6,8,13,14,15). Especially high incidence of restrictive (up to 47%) and diffusion lung function disorders (up to 62%) is common after bone marrow transplantation, being higher in patients treated with total body irradiation and/or experiencing graftversus-host disease (13,(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

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Late Pulmonary Sequelae After Treatment of Childhood Cancer

2014

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Objective -Increasingly successful treatment of childhood cancer during the last decades, resulting in a number of long term survivors, has made it possible to study late sequelae of this treatment in sizable cohorts of survivors. The aims were to determine the frequency and severity of pulmonary late sequelae among children treated for cancer to identify treatment risk factors and the methods for continued followup. Materials and methods -In 255 of the 1020 survivors, at least 18 years old, 5 years after treatment, who agreed with the examination protocol, testing was performed at the time of their follow up appointment. It was conducted 5 to 37 (mean 18) years after diagnosis. The examinations included physical examination, chest radiograms and pulmonary function testing. Results -Radiograms revealed 79 abnormalities in 53 patients and were most frequently found in patients with Hodgkin's disease (20/67) or non-Hodgkin's lymphoma treated with mediastinal radiotherapy (RT) (10/31), in patients with brain tumor treated with RT to the central nervous axis (CNA) (7/15), in Wilms' tumor patients, who had abdominal RT, scoliosis was found. (6/15). Lung function tests showed abnormal values, mostly restrictive changes, in 59 of 237 patients. Conclusion -Late pulmonary sequelae after treatment of childhood cancer are rare serious or life-threatening complications. Radiographic and pulmonary function abnormalities were most frequently found in patients who had mediastinal or CNA RT. Regular follow-up of these patients is therefore recommended. Spirometry has been a useful test for detection of pulmonary sequelae. Routinely follow-up radiography is always indicated in clinical suspicion of secondary tumors.

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“…Following treatment for acute lymphoblastic leukaemia, there are usually no evident clinical symptoms of respiratory failure; however, symptoms of restrictive lung disease may appear. The symptoms may result from the application of anthracyclines and circulatory failure, CNS radiotherapy and exposure to methotrexate, cytosine arabinoside and cyclophosphamide [34,35].…”

Section: The Respiratory Systemmentioning

confidence: 99%

Late mortality of long-term survivors of childhood cancer

Krawczuk‐Rybak¹

2011

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In the last four decades there has been enormous progress in the treatment for childhood cancer; the present 5-year survival rate is estimated to be 80%. The increased population of cancer survivors gives us the possibility to assess life quality as well as the late effects of anticancer treatment. In multicentre studies, it has been shown that 60% of survivors have at least one late effect, and one third experience severe or lifethreatening sequelae. Survivors of childhood cancers are at risk of recurrence of primary malignancy, development of second cancer and chronic disease of the respiratory and cardiovascular system, which increase the mortality rate. Other late complications, such as diseases affecting kidneys, digestive system or bones, and hormonal and metabolic disturbances lead to deterioration of life quality. This report presents treatment-related factors that increase mortality of cancer survivors by contributing to the development of second cancers, cardiotoxicity or pulmonary complications. K Ke ey y w wo or rd ds s: : children, cancer survivors, late effects, second cancers, cardiotoxicity, lung toxicity, late mortality. The significant progress observed over the last 40 years in the diagnostics and treatment for cancer in children has caused an improvement in 5-year event-free survival (EFS) up to 80%. Before 1970, anticancer therapy involved mainly radiotherapy and surgery. Later, chemotherapy began to play a role. In subsequent years, the chemotherapy programmes were modified and so were the radiotherapy and surgery programmes. Both single-centre and multicentre studies on the health condition of long-term survivors of childhood cancer have focused on the causes of premature deaths of patients treated for cancer in childhood. Until 1970, the major cause of mortality was recurrence of primary tumour (over 70%). Research conducted in recent years has demonstrated the highest mortality rate among patients treated for CNS cancer (11-15%), leukaemia (12-14%) and bone tumours (10-16%), and the lowest for retinoblastoma (2-5%) and Wilms tumour (3-4%) [1]. EpidemiologyAs shown by epidemiological data, in the USA one out of 640 young adults aged 20-39 years is a long-term survivor of childhood cancer. Fairly representative groups of several or even tens of thousands of childhood cancer survivors have been observed since 1940 in the United States, Canada, Germany, Great Britain and Italy [2][3][4]. This allows for a multidirectional analysis of health condition, organ function and life quality of an increasing number of survivors, and promotes the changes in radiotherapy and chemotherapy techniques.The largest multidirectional investigations carried out in the United States as part of the Childhood Cancer Survivor Study (CCSS) in a group of over 20 thousand survivors indicate that more than 60% of them have a chronic disorder and 27.5% have a severe life-threatening disease [5]. Of the group of 20,483 patients diagnosed in the years 1970-1986, 2821 died. The most common cause of death was progression o...

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Pulmonary function after treatment for acute lymphoblastic leukaemia in childhood

Cited by 39 publications

References 19 publications

Adverse Late Effects of Childhood Cancer and Its Treatment on Health and Performance

Adverse Late Effects of Childhood Cancer and Its Treatment on Health and Performance

Late Pulmonary Sequelae After Treatment of Childhood Cancer

Late mortality of long-term survivors of childhood cancer

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