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Langzeitfolgen der Akuten Myeloischen Leukämie und ihrer Behandlung

Sind die aktuellen Nachsorgeempfehlungen ausreichend?

Long-term effects of acute myeloid leukemia and its treatment

Are current aftercare recommendations sufficient?

  • Psychoonkologie
  • Published:
Die Onkologie Aims and scope

Zusammenfassung

Hintergrund

Durch modernere Behandlungsoptionen hat sich die Prognose der akuten myeloischen Leukämie (AML) verbessert. Dadurch gewinnen Spätfolgen der Erkrankung und ihrer Behandlung immer mehr an Bedeutung. Zurzeit ist keine umfassende Nachsorgeempfehlung verfügbar, da die Datengewinnung unter anderem durch die relative Seltenheit der Erkrankung erschwert wird.

Ergebnisse

Aus Untersuchungen von Langzeitüberlebenden verschiedener anderer Tumorentitäten sind bereits häufig auftretende gesundheitliche Spätfolgen und Problembereiche bekannt. Einige davon konnten auch bei AML-Überlebenden identifiziert werden. Aus psychosozialer Sicht können basierend auf den vorhandenen Daten eine erhöhte Prävalenz von Depression, Angst und Fatigue sowie vermehrte finanzielle Sorgen beobachtet werden. Zudem ist das Risiko für verschiedene somatische Komorbiditäten wie kardiovaskuläre Erkrankungen und Sekundärmalignome bei AML-Langzeitüberlebenden erhöht.

Schlussfolgerung

Ergänzend zu regelmäßigen Kontrollen des Remissionsstatus sollten bei der Behandlung von Langzeitüberlebenden einer AML auch psychosoziale und somatische Begleit- und Folgeerkrankungen in der Nachsorge berücksichtigt werden. Außerdem sollte eine Ausweitung des intensiven Nachsorgeintervalls länger als fünf Jahre seit der Erstdiagnose erwogen werden. Weitere Studien zu Langzeitfolgen der Erkrankung sind zur Optimierung der Nachsorge von ehemaligen AML-Patienten nötig.

Abstract

Background

With the increasing number of long-term survivors after acute myeloid leukemia (AML), long-term effects of the disease and its treatment become increasingly important. Due to various factors, like the rareness of the disease, guidelines for survivorship care plans are difficult to establish on the basis of existing studies.

Results

Looking at various studies including cancer survivors of various cancer entities, different problem areas have already been identified in long-term survivors. Some of those can be added to the data available for AML long-term survivors. From a psychosocial point of view, higher prevalence for depression, anxiety, fatigue and financial toxicity have been observed. In addition, the risk for certain somatic comorbidities, like cardiovascular comorbidities and secondary malignancies, is increased.

Conclusion

Aside from regular monitoring of the remission status, psychosocial and somatic comorbidities should also be monitored by the physician when caring for long-term survivors after AML. In addition, intensive aftercare intervals should be extended further than 5 years after initial diagnosis. Future research on long-term effects of the disease is still needed to optimize care for AML long-term survivors.

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Literatur

  1. Abrahão R, Huynh JC, Benjamin DJ et al (2021) Chronic medical conditions and late effects after acute myeloid leukaemia in adolescents and young adults: a population-based study. Int J Epidemiol 50:663–674

    Article  Google Scholar 

  2. Bower H, Andersson TM, Björkholm M et al (2016) Continued improvement in survival of acute myeloid leukemia patients: an application of the loss in expectation of life. Blood Cancer J 6:e390

    Article  CAS  Google Scholar 

  3. Boyiadzis M, Arora M, Klein JP et al (2015) Impact of chronic graft-versus-host disease on late relapse and survival on 7,489 patients after myeloablative allogeneic hematopoietic cell transplantation for leukemia. Clin Cancer Res 21:2020–2028

    Article  Google Scholar 

  4. Chang KH, Hwang WL, Muo CH et al (2016) Outcome and late effects among acute myeloid leukemia survivors: a nationwide population-based study. Support Care Cancer 24:4993–5000

    Article  Google Scholar 

  5. Cheng MJ, Hourigan CS, Smith TJ (2014) Adult acute myeloid leukemia long-term survivors. J Leuk (Los Angel) 2(2):26855

    Google Scholar 

  6. Crowther D, Bateman CJ, Vartan CP et al (1970) Combination chemotherapy using L‑asparaginase, daunorubicin, and cytosine arabinoside in adults with acute myelogenous leukaemia. Br Med J 4(5734):513–517

    Article  CAS  Google Scholar 

  7. Delgado-Guay M, Ferrer J, Rieber AG et al (2015) Financial distress and its associations with physical and emotional symptoms and quality of life among advanced cancer patients. Oncologist 20:1092–1098

    Article  Google Scholar 

  8. Erdmann F, Spix C, Katalinic A et al (2021) Krebs in Deutschland für 2017/2018, 13. Aufl. Robert Koch-Institut, Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V., Berlin, S 172

    Google Scholar 

  9. Frick M, Chan W, Arends CM et al (2019) Role of donor clonal hematopoiesis in allogeneic hematopoietic stem-cell transplantation. J Clin Oncol 37:375–385

    Article  CAS  Google Scholar 

  10. Guerra VA, Dinardo C, Konopleva M (2019) Venetoclax-based therapies for acute myeloid leukemia. Best Pract Res Clin Haematol 32:145–153

    Article  Google Scholar 

  11. Hartung TJ, Brähler E, Faller H et al (2017) The risk of being depressed is significantly higher in cancer patients than in the general population: prevalence and severity of depressive symptoms across major cancer types. Eur J Cancer 72:46–53

    Article  CAS  Google Scholar 

  12. Hecker JS, Hartmann L, Rivière J et al (2021) CHIP and hips: clonal hematopoiesis is common in patients undergoing hip arthroplasty and is associated with autoimmune disease. Blood 138:1727–1732

    Article  CAS  Google Scholar 

  13. Hills RK (2012) The contribution of randomized trials to the cure of haematological disorders from Bradford Hill onwards. Br J Haematol 158:691–699

    Article  Google Scholar 

  14. Kuhnt S, Szalai C, Erdmann-Reusch B et al (2017) Cancer related fatigue in rehabilitation care. Rehabilitation 56:337–343

    Article  Google Scholar 

  15. Major CK, Kantarjian H, Sasaki K et al (2020) Survivorship in AML—a landmark analysis on the outcomes of acute myelogenous leukemia patients after maintaining complete remission for at least 3 years. Leuk Lymphoma 61:3120–3127

    Article  Google Scholar 

  16. Mehnert A (2011) Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol 77(2):109–130

    Article  Google Scholar 

  17. Messerer D, Engel J, Hasford J et al (2008) Impact of different post-remission strategies on quality of life in patients with acute myeloid leukemia. Haematologica 93:826–833

    Article  Google Scholar 

  18. Mitchell AJ, Ferguson DW, Gill J et al (2013) Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis. Lancet Oncol 14:721–732

    Article  Google Scholar 

  19. Moret AS, Telzerow E, Rothenberg-Thurley M et al (2021) High prevalence of CHF and diabetes in AML long-term survivors—a patient forever? Blood 138:4127

    Article  Google Scholar 

  20. National Cancer Institute (2021) Cancer stat facts: leukemia—acute myeloid leukemia (AML)

    Google Scholar 

  21. National Comprehensive Cancer Network (2021) NCCN guidelines version 1.2022 actue myleoid leukemia (age ≥18 years)

    Google Scholar 

  22. Neuendorff NR, Loh KP, Mims AS et al (2020) Anthracycline-related cardiotoxicity in older patients with acute myeloid leukemia: a Young SIOG review paper. Blood Adv 4:762–775

    Article  CAS  Google Scholar 

  23. Onkopedia (2021) Akute Myeloische Leukämie (AML). https://www.onkopedia.com/de/onkopedia/guidelines/akute-myeloische-leukaemie-aml/@@guideline/html/index.html. Zugegriffen: 19. Dez. 2021

  24. Pandya DM, Patel S, Ketchum NS et al (2011) A comparison of races and leukemia subtypes among patients in different cancer survivorship phases. Clin Lymphoma Myeloma Leuk 11(Suppl 1):S114–S118

    Article  Google Scholar 

  25. Rothenberg-Thurley M, Amler S, Goerlich D et al (2018) Persistence of pre-leukemic clones during first remission and risk of relapse in acute myeloid leukemia. Leukemia 32:1598–1608

    Article  CAS  Google Scholar 

  26. Rüffer JU, Flechtner H, Tralls P et al (2003) Fatigue in long-term survivors of Hodgkin’s lymphoma; a report from the German Hodgkin Lymphoma Study Group (GHSG). Eur J Cancer 39:2179–2186

    Article  Google Scholar 

  27. Shah A, Andersson TM, Rachet B et al (2013) Survival and cure of acute myeloid leukaemia in England, 1971–2006: a population-based study. Br J Haematol 162:509–516

    Article  Google Scholar 

  28. Telzerow E, Görlich D, Rothenberg-Thurley M et al (2021) Quality of life and life satisfaction in AML long-term survivors: primary results of the AMLCG-survivorship study. Blood 138:2289

    Article  Google Scholar 

  29. Tichelli A, Bhatia S, Socié G (2008) Cardiac and cardiovascular consequences after haematopoietic stem cell transplantation. Br J Haematol 142:11–26

    Article  Google Scholar 

  30. Wolff D, Herzberg PY, Herrmann A et al (2021) Post-transplant multimorbidity index and quality of life in patients with chronic graft-versus-host disease-results from a joint evaluation of a prospective German multicenter validation trial and a cohort from the National Institutes of Health. Bone Marrow Transplant 56:243–256

    Article  Google Scholar 

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Authors and Affiliations

  1. Klinikum der Universität München, Marchioninistr. 15, 81377, München, Deutschland

    Eva Telzerow

Authors
  1. Anna S. Moret
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  2. Dennis Görlich
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  3. Maria C. Sauerland
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  4. Klaus H. Metzeler
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  5. Eva Telzerow
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Correspondence to Eva Telzerow.

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Interessenkonflikt

A.S. Moret, D. Görlich, M.C. Sauerland, K.H. Metzeler und E. Telzerow geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Moret, A.S., Görlich, D., Sauerland, M.C. et al. Langzeitfolgen der Akuten Myeloischen Leukämie und ihrer Behandlung. Onkologie 28, 519–523 (2022). https://doi.org/10.1007/s00761-022-01129-4

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  • DOI: https://doi.org/10.1007/s00761-022-01129-4

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