Survivors of adolescent and young adult (AYA) acute lymphoblastic leukemia (ALL) may experience late effects, with a high incidence of subsequent endocrine disease and cardiac disease, according to a study published in the August issue of JNCI Cancer Spectrum.
Lori Muffly, M.D., from Stanford University in California, and colleagues examined late effects in 1,069 AYAs (aged 15 to 39 years) diagnosed with ALL in California between 1995 and 2012 and surviving for a minimum of three years.
The researchers observed a high estimated 10-year cumulative incidence of subsequent endocrine disease and cardiac disease (28.7 and 17.0 percent, respectively). The estimated frequencies of avascular necrosis, liver disease, respiratory disease, seizure and/or stroke, renal disease, and second neoplasms at 10 years were 9.6, 6.5, 6.2, 4.3, 3.1, and 1.4 percent, respectively. Independent associations with the occurrence of all late effects were seen for public or no insurance versus private and/or military insurance and receipt of hematopoietic cell transplantation. In analyses of the 766 AYAs who were not transplanted, there was a statistically significant association of public and no insurance with the occurrence of all late effects. There was no significant association noted for frontline regimen type (pediatric versus adult) with any of the late-effect categories.
“Prospective population-based studies with longer follow-up would further inform the development of AYA-specific survivorship guidelines,” the authors write.
One author disclosed financial ties to pharmaceutical companies, including Servier, which partially funded the study.