Researchers in the US have examined the risk of long-tem chronic side-effects in patients who have survived acute myeloid leukaemia (AML) in adolescence or early adulthood. Their findings suggest that late effects may sometimes be linked to socio-economic factors and other health disparities, rather than to the original disease or its treatment.
Dr Theresa Keegan, at the UC Davis Comprehensive Cancer Center, Sacramento, USA, and colleagues looked at ten-year follow-up information from 1,168 patients treated for AML as teenagers or young adults between 1996 and 2012.
Among these patients, now aged 15 to 39 years, 26% had developed an endocrine disease, 19% a cardiovascular disease, and 7% a respiratory disease. The team found other, less frequent late effects, including a second cancer.
Patients who received a bone marrow transplant had the highest risk, being twice as likely to experience most of the late effects.
Hispanic, Black and Asian/Pacific Islander patients, and those who lived in poorer areas at the time of first diagnosis also faced extra risk.
“This higher risk may relate to the financial hardship that patients with cancer often experience,” explains Dr Keegan. “As a result of cancer, adolescent and young adult survivors and their families may miss work, experience income loss and incur substantial out-of-pocket expenses.”
The research appeared last week in the International Journal of Epidemiology.
Lead author Dr Renata Abrahão said: “Our study sheds light on the high burden of late effects among young survivors of acute myeloid leukaemia. Our findings can help clinicians and policymakers develop better survivorship care plans to reduce suffering and death among adolescent and young adult survivors.”
Abrahão R, Huynh JC, Benjamin DJ, Li QW, Winestone LE, Muffly L, Keegan THM. (2020) “Chronic medical conditions and late effects after acute myeloid leukemia in adolescents and young adults: a population-based study.” International Journal of Epidemiology; doi: 10.1093/ije/dyaa184
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