Topics in Pediatric Leukemia -- Acute Lymphoblastic Leukemia and Late Effects in Long-Term Survivors

Jacqueline Casillas, MD, MSHS; Kathleen M. Sakamoto, MD, PhD

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Introduction

The success in the treatment for acute lymphoblastic leukemia (ALL) over the last 30 years has significantly contributed to the growing number of pediatric cancer survivors. It is currently estimated that the overall survival rate for children diagnosed with ALL is 80%.[1,2] There were more than 270,000 childhood cancer survivors in the United States in 1997, which translates into 1 of 640 adults aged 20-39 years and 95,000 survivors who are less than 20 years of age who have a history of childhood cancer.[3,4]

As the population of childhood cancer survivors continues to grow, however, evidence is increasing that cure from the primary malignancy is not without long-term complications. Virtually every organ system is at risk for the development of a late effect owing to exposure to surgery, chemotherapy, radiation therapy, and/or supportive care regimens.

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