Renal, gastrointestinal, and hepatic late effects in survivors of childhood acute myeloid leukemia treated with chemotherapy only-A NOPHO-AML study

Skou, Anne-Sofie; Glosli, Heidi; Jahnukainen, Kirsi; Jarfelt, Marianne; Jónmundsson, Guđmundur; Malmros-Svennilson, Johan; Nysom, Karsten; Hasle, Henrik

doi:10.1002/pbc.25069

Cited by 16 publications

(15 citation statements)

References 21 publications

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“…Renal abnormalities have been observed in AML survivors but most were treated with HSCT (Liesner et al, 1994;Leahey et al, 1999). Patients treated with chemotherapy alone have relatively few late renal and gastrointestinal late effects (Skou et al, 2014a).…”

Section: Renal and Gastrointestinalmentioning

confidence: 99%

Strategies for reducing the treatment‐related physical burden of childhood acute myeloid leukaemia – a review

Hasle

Kaspers

2016

Br J Haematol

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Over the last four decades the survival of paediatric patients with acute myeloid leukaemia has gradually increased to 70% in high-income countries. The therapy is very intensive and associated with many acute and long-term side effects. The early death rate has been reduced to 1-4%. The acute toxicity is a limiting factor for improving survival in low-income countries. Transplant is associated with more endocrinological late effects while cardiotoxicity is more common after relapse. Reducing the physical costs of therapy without jeopardizing survival may be accomplished by optimal supportive care, less cardiotoxic anthracyclines, less consolidation courses and strict indications for stem cell transplantation. Analysing scenarios with different frequency of transplantation in first complete remission show similar overall survival rates, indicating that almost all patients can be spared the procedure in first remission. Reducing relapse risk is an effective way of reducing toxicity and more targeted therapy and improved risk group stratifications are needed.

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Section: Renal and Gastrointestinalmentioning

confidence: 99%

Strategies for reducing the treatment‐related physical burden of childhood acute myeloid leukaemia – a review

Hasle

Kaspers

2016

Br J Haematol

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“…A systematic review of 20 cohort studies investigating hepatic late adverse effects after antineoplastic treatment for childhood cancer is inconclusive . High cumulated doses of anthracyclines are used in acute myeloid leukaemia (AML) but liver diseases are uncommon in non‐transplanted patients . Some studies have suggested that the use of methotrexate induces mild structural changes of the liver that may lead to fibrosis/cirrhosis, although it rarely causes end‐stage liver disease .…”

Section: Discussionmentioning

confidence: 99%

“…Iron overload due to multiple transfusions is common in long‐term survivors . Despite significant iron overload after multiple transfusions in patients without HSCT it is often without signs of liver damage . Iron overload can increase the risk of infections, VOD and hepatic dysfunction …”

Section: Discussionmentioning

confidence: 99%

Liver diseases in Adult Life after Childhood Cancer in Scandinavia (ALiCCS): A population‐based cohort study of 32,839 one‐year survivors

Bonnesen

Winther

Andersen

et al. 2017

Intl Journal of Cancer

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Information on late onset liver complications after childhood cancer is scarce. To ensure an appropriate follow-up of childhood cancer survivors and reducing late liver complications, the need for comprehensive and accurate information is presented. We evaluate the risk of liver diseases in a large childhood cancer survivor cohort. We included all 1-year survivors of childhood cancer treated in the five Nordic countries. A Cox proportional hazards model was used to estimate hospitalisation rate (hazard) ratios (HRs) for each liver outcome according to type of cancer. We used the risk among survivors of central nervous system tumour as internal reference. With a median follow-up time of 10 years, 659 (2%) survivors had been hospitalised at least once for a liver disease. The risk for hospitalisation for any liver disease was high after hepatic tumour (HR = 6.9) and leukaemia (HR = 1.7). The Danish sub-cohort of leukaemia treated with haematopoietic stem cell transplantation had a substantially higher risk for hospitalisation for all liver diseases combined (HR = 3.8). Viral hepatitis accounted for 286 of 659 hospitalisations corresponding to 43% of all survivors hospitalised for liver disease. The 20-year cumulative risk of viral hepatitis was 1.8% for survivors diagnosed with cancer before 1990 but only 0.3% for those diagnosed after 1990. The risk of liver disease was low but significantly increased among survivors of hepatic tumours and leukaemia. Further studies with focus on the different treatment modalities are needed to further strengthen the prevention of treatment-induced late liver complications.

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“…According to a study carried out by Skou et al. () focusing on survivors of AML, 14 (14%) of the survivors experienced recurrent UTIs and 12 (85%) of these are women. In the literature, it is indicated that girls are more prone to UTIs due to some anatomical reasons, such as shorter urethras (Tezer & Ceyhan, ).…”

Section: Discussionmentioning

confidence: 99%

“…In conjunction with these problems, it is observed that 67 ( In our study, it was determined that the gender of the children affects the incidence of UTIs and burning and pain during urination, both of which were observed more frequently in women than in men (p < .05) ( Table 5). According to a study carried out by Skou et al (2014) focusing on survivors of AML, 14 (14%) of the survivors experienced recurrent UTIs and 12 (85%) of these are women. In the literature, it is indicated that girls are more prone to UTIs due to some anatomical reasons, such as shorter urethras (Tezer & Ceyhan, 2007).…”

Section: Discussionmentioning

confidence: 99%

Assessment of problems and symptoms in survivors of childhood acute lymphoblastic leukaemia

Arpaci

Törüner

2016

Eur J Cancer Care

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Significant physical and psychosocial problems and related symptoms are observed in cancer survivors after treatment as well as during the treatment period. This study was aimed to assess problems and symptoms in childhood acute lymphoblastic leukaemia (ALL) survivors. Study was applied in three hospitals in Ankara/Turkey with 91 children who were diagnosed and treated with ALL and with their family. Data were collected using the data collection form developed by the researchers. The variables were investigated using the Mann-Whitney U and chi-square test. The most common physical problems and symptoms seen in survivors are respiratory system infections (40.7%), reduction in bone mineral density (26.4%), exercise intolerance (45.1%), pain (41.8%) and fatigue (29.7%). Among the most frequent social problems experienced, educational problems (19.8%) is indicated. In children carrying increased duration of therapy, urinary system infections (p = .016), anorexia (0.020) and pain (p = .007) rates are increasing. Many problems and symptoms related to disease and treatment in survivors of ALL have been realised. Therefore, planning and implementation of nursing interventions required to sustaining and developing survivor's health status are important.

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Renal, gastrointestinal, and hepatic late effects in survivors of childhood acute myeloid leukemia treated with chemotherapy only-A NOPHO-AML study

Abstract: Survivors of childhood AML treated with chemotherapy only experienced few renal, gastrointestinal, and hepatic late effects.

Cited by 16 publications

References 21 publications

Strategies for reducing the treatment‐related physical burden of childhood acute myeloid leukaemia – a review

Strategies for reducing the treatment‐related physical burden of childhood acute myeloid leukaemia – a review

Liver diseases in Adult Life after Childhood Cancer in Scandinavia (ALiCCS): A population‐based cohort study of 32,839 one‐year survivors

Assessment of problems and symptoms in survivors of childhood acute lymphoblastic leukaemia

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