Volumen: 17 # Number : 3
Publication Date : Septiembre - Diciembre Year: 2013
Long-term toxicity of treatment childhood
acute lymphoblastic leukemia (ALL)
Authors: Cuns DI, Lagrotta PI
Abstract: The achievment of cure in childhood cáncer increased in the past-decades, been the acute lymphoblastic leukemia the most common neoplasm, with an incidence near 3.9 new cases per 100.000/yaer, it represents the 25% of all cancers in the younger population (under 15 years old).
Multimodal therapy and enhanced supportive care have resulted in 5 year survival rates of 75%, thus, there is an importance in identify the long term toxicity of these treatment,
there has recently been an increased in the number of adult surviviors of childhood ALL, in this population wee need to evaluate the damage in the different organs: liver, endocrine disorders, lung, kidney, etc.
One important aspect is the elevated risk for second malignancies,
and, a very important point of evaluation in the post-traumatic stress síndrome and the social abilities of the surviviors.
The report from the Childhood Cancer Survivior (from Canada and USA) shhown an increase risk of deaht for heart disease, leukemia surviviors have an elevated risk of myocardial infraction, congestive heart failure and pericardial
desease do to anthracycline damage to the myocardium.
There is an increased risk of obesity, endocrine and metabolic
disorders, muscle weakness, neurosensory and neruocognitive impairments. One of the most serius late sequelae is the development of second malignanat neoplasm (SMNs), several large cohort
studies showed there were 3 to 5 folds increased in the ocurrence of SMNs among chilhood cáncer surviviors compared to general population. Radiotherapy is an important
risk factor for the development of SMNs, specially solid tumors within the radioation field, and central nervous
system tumors ( meningiomas and gliomas are the most commonly ocurring latent brain tumors in leukemia surviviors), second acute myeloid leukemia and myelodisplastic
síndrome have been related to chemotherapeutic
agents.
The aim of these work is to describe the long-term toxicity that these surviviors develop and to compare the data of the references with the experience in our center.
Key words: toxicity, acute lymphoblastic leukemia,
radioterapy, chemotherapy.
Pages : 223-230
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